Lily N Clarkson, FNP
Individual provider Active NPI Nurse Practitioner · San Andreas, CA
NPI 1487091450 · NPPES record last updated Jul 26, 2013
Key facts
- NPI
- 1487091450
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- NP7118 (CA)
- Practice address
- 1113 Hwy 49
San Andreas, CA 95249 - Phone
- (209) 755-1400
- Fax
- (209) 755-1430
- NPI assigned
- May 30, 2013
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| NP7118 | CA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP7118 | CA | Yes |
Addresses
Primary practice location
1113 Hwy 49
San Andreas, CA 95249
Mailing address
PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6240
Other providers in San Andreas, CA
- Center for Life Skills Coaching
- Cep America - California
- Mary Chase
- Joshua David Christie
- Cesar Clarin
- Community Medical Centers
- Community Medical Centers
- Community Medical Team Acute Care Corporation
- Michael Compton
- Kulauri Cooper
All providers in San Andreas, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.