Provider Demographics
NPI:1215687892
Name:KLEMAS, MARCELLA DIANNE (FNP-C)
Entity type:Individual
Prefix:
First Name:MARCELLA
Middle Name:DIANNE
Last Name:KLEMAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 LASCASSAS PIKE
Mailing Address - Street 2:
Mailing Address - City:LASCASSAS
Mailing Address - State:TN
Mailing Address - Zip Code:37085-4511
Mailing Address - Country:US
Mailing Address - Phone:615-603-7445
Mailing Address - Fax:615-603-7447
Practice Address - Street 1:4712 LASCASSAS PIKE
Practice Address - Street 2:
Practice Address - City:LASCASSAS
Practice Address - State:TN
Practice Address - Zip Code:37085-4511
Practice Address - Country:US
Practice Address - Phone:615-603-7445
Practice Address - Fax:615-603-7447
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily