Provider Demographics
NPI:1871597476
Name:CLEMENTE, MEGHAN E (ANP-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:CLEMENTE
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:E
Other - Last Name:MCGANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-C
Mailing Address - Street 1:1270 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2014
Mailing Address - Country:US
Mailing Address - Phone:732-615-3900
Mailing Address - Fax:732-615-0865
Practice Address - Street 1:1270 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748
Practice Address - Country:US
Practice Address - Phone:732-615-3900
Practice Address - Fax:732-615-0185
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09409300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ043579DE4OtherMEDICARE
NJ8360405Medicaid
NJ043579DE4OtherMEDICARE