Provider Demographics
NPI:1447201314
Name:SCLAIR, LU H (ANP)
Entity type:Individual
Prefix:MS
First Name:LU
Middle Name:H
Last Name:SCLAIR
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 JOHN R WOODEN DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-1840
Mailing Address - Country:US
Mailing Address - Phone:765-342-3364
Mailing Address - Fax:
Practice Address - Street 1:1949 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-1861
Practice Address - Country:US
Practice Address - Phone:765-342-3364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001992A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71001992AOtherNURSE PRACTITIONER LICENS
IN71001992BOtherCSR
IN28110557AOtherREGISTERED NURSE LICENSE
IN28110557AOtherREGISTERED NURSE LICENSE