Provider Demographics
NPI:1932441987
Name:CLEMENTS, JENNIFER HARSHAW (CFNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HARSHAW
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 N BROOKMOORE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2024
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-864-7565
Practice Address - Street 1:7474 HIGHWAY 45 ALT N
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-7981
Practice Address - Country:US
Practice Address - Phone:662-494-5863
Practice Address - Fax:662-494-5287
Is Sole Proprietor?:No
Enumeration Date:2013-03-17
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR867470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F0113156OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM