Provider Demographics
NPI:1750699914
Name:CLEMENS, BARBARA ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:CLEMENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:37952 201ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE GEORGE
Mailing Address - State:MN
Mailing Address - Zip Code:56458-4067
Mailing Address - Country:US
Mailing Address - Phone:218-699-3086
Mailing Address - Fax:
Practice Address - Street 1:110 3RD ST S
Practice Address - Street 2:
Practice Address - City:HACKENSACK.
Practice Address - State:MN
Practice Address - Zip Code:56452
Practice Address - Country:US
Practice Address - Phone:218-675-5044
Practice Address - Fax:218-675-5048
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR91033-6363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily