Provider Demographics
NPI:1306260542
Name:CLARY, HOPE WAKEFIELD (NP)
Entity type:Individual
Prefix:MS
First Name:HOPE
Middle Name:WAKEFIELD
Last Name:CLARY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2051 SILVERSIDE DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9005
Mailing Address - Country:US
Mailing Address - Phone:225-490-8882
Mailing Address - Fax:225-765-9085
Practice Address - Street 1:4336 NORTH BLVD
Practice Address - Street 2:#201
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3920
Practice Address - Country:US
Practice Address - Phone:225-343-9505
Practice Address - Fax:225-343-9141
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2015-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN122737AP07260363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2359622Medicaid