Provider Demographics
NPI:1851662498
Name:CLEAR, LAUREN L (PA)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:L
Last Name:CLEAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:R
Other - Last Name:LOVEDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 52948
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-2948
Mailing Address - Country:US
Mailing Address - Phone:865-306-5675
Mailing Address - Fax:865-584-7712
Practice Address - Street 1:7714 CONNER RD STE 103
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3559
Practice Address - Country:US
Practice Address - Phone:865-938-8121
Practice Address - Fax:865-212-5561
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA2083363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1527757Medicaid
TN1527757Medicaid