Healthcare Provider Details

I. General information

NPI: 1265222533
Provider Name (Legal Business Name): JOSSANE MCCLANTOC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOSSANE KEMOYA ALLEN CRNP

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR
MOBILE AL
36617-2300
US

IV. Provider business mailing address

PO BOX 36258
BELFAST ME
04915-1204
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7870
  • Fax: 251-460-7923
Mailing address:
  • Phone: 251-318-2678
  • Fax: 251-405-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-160259
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: