Provider Demographics
NPI:1891500310
Name:CLEMENTS, RAYSHAWN
Entity type:Individual
Prefix:
First Name:RAYSHAWN
Middle Name:
Last Name:CLEMENTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23670 BANBURY CIR APT 1
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5359
Mailing Address - Country:US
Mailing Address - Phone:216-905-1131
Mailing Address - Fax:
Practice Address - Street 1:23670 BANBURY CIR APT 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5359
Practice Address - Country:US
Practice Address - Phone:216-905-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide