MEDICARE: DARNESHA SHAUNTE CLANTON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP145799	TX

General Provider Information

NPI Number	:	1730799917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARNESHA SHAUNTE CLANTON NP

Provider Business Mailing Address
First Line	:	2916 INWOOD RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7518
Country	:	US
Telephone Number	:	214-466-6618
Fax Number	:

Provider Business Practice Location Address
First Line	:	2916 INWOOD RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7518
Country	:	US
Telephone Number	:	214-466-6618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2020
Last Update Date	:	09/27/2024

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