Provider Demographics
NPI:1174988679
Name:CLARKE, ARLENE (LPN)
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 FARMSTEAD LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2012
Mailing Address - Country:US
Mailing Address - Phone:860-985-5714
Mailing Address - Fax:
Practice Address - Street 1:20 FARMSTEAD LN
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2012
Practice Address - Country:US
Practice Address - Phone:860-985-5714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH159599164W00000X
TX222095164W00000X
CT026749164W00000X
MALN93257164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse