Provider Demographics
NPI:1285303404
Name:MCCLATCHIE, CLAUDETTE (RN)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:
Last Name:MCCLATCHIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7385 NW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-6302
Mailing Address - Country:US
Mailing Address - Phone:134-336-2928
Mailing Address - Fax:
Practice Address - Street 1:961 EASTERN PKWY APT C10
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4608
Practice Address - Country:US
Practice Address - Phone:347-336-2928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340665163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse