Provider Demographics
NPI:1912414384
Name:CLARKE, JULIE ANN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:CLARKE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 AMBERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-8717
Mailing Address - Country:US
Mailing Address - Phone:864-607-4766
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2169
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29071-2169
Practice Address - Country:US
Practice Address - Phone:803-358-8496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201709775NP207Q00000X, 363LF0000X
AZ267045363LF0000X
FL11015286363LF0000X
WAAP60825540363LF0000X
WA60825540363LF0000X
SC25993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine