Provider Demographics
NPI:1154033736
Name:IJAMS, CLAY CORPENING (AGPCNP)
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:CORPENING
Last Name:IJAMS
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:704-443-6250
Mailing Address - Fax:
Practice Address - Street 1:2030 WINDSOR RUN LN
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-0054
Practice Address - Country:US
Practice Address - Phone:704-443-6250
Practice Address - Fax:704-443-6279
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251202363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health