Alicia Janelle Clem, LPN

Individual provider Active NPI Licensed Practical Nurse · Cabot, AR

NPI 1407588403 · NPPES record last updated Jun 28, 2022

Key facts

NPI
1407588403
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L050380 (AR)
Practice address
502 Richie Rd
Cabot, AR 72023-3309
Phone
(501) 941-0940
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L050380ARMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L050380 AR Yes

Addresses

Primary practice location

502 Richie Rd
Cabot, AR 72023-3309

Mailing address

904 N Lemon St
Beebe, AR 72012-2730
Phone (501) 286-3245

Other providers in Cabot, AR

All providers in Cabot, AR · Licensed Practical Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.