Provider Demographics
NPI:1891747531
Name:CLEMENTS, RONDA LEE (APN)
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:LEE
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1068 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-8433
Mailing Address - Country:US
Mailing Address - Phone:870-886-5553
Mailing Address - Fax:870-886-1722
Practice Address - Street 1:1050 W FREE ST
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-1752
Practice Address - Country:US
Practice Address - Phone:870-886-3201
Practice Address - Fax:870-886-1722
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA01031363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology