Provider Demographics
NPI:1063751113
Name:CLAYTON, RITA JANE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:JANE
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:JANE
Other - Last Name:LENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-6661
Mailing Address - Fax:717-851-6091
Practice Address - Street 1:430 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-1123
Practice Address - Country:US
Practice Address - Phone:717-851-6500
Practice Address - Fax:717-755-3435
Is Sole Proprietor?:No
Enumeration Date:2013-02-10
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012534363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA277979FLTMedicare PIN