Provider Demographics
NPI:1063172708
Name:CLEMENTS, EVA MARIE (APRN)
Entity type:Individual
Prefix:
First Name:EVA MARIE
Middle Name:
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12532 DRAYTON DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-4225
Mailing Address - Country:US
Mailing Address - Phone:352-585-6266
Mailing Address - Fax:
Practice Address - Street 1:8425 NORTHCLIFFE BLVD STE 109
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1107
Practice Address - Country:US
Practice Address - Phone:352-683-5141
Practice Address - Fax:352-683-6546
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017252363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily