Provider Demographics
NPI:1316271661
Name:CLANCY, CLAUDIA A (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:A
Last Name:CLANCY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:4708 ALLIANCE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5339
Practice Address - Country:US
Practice Address - Phone:972-596-7801
Practice Address - Fax:972-596-9307
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX702691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01752680OtherRAILROAD
TX206277002Medicaid
TX206277002Medicaid