Healthcare Provider Details

I. General information

NPI: 1114846235
Provider Name (Legal Business Name): TASHA C CLAYTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N C ST
NORTH LITTLE ROCK AR
72114-4414
US

IV. Provider business mailing address

800 N C ST
NORTH LITTLE ROCK AR
72114-4414
US

V. Phone/Fax

Practice location:
  • Phone: 501-553-5348
  • Fax:
Mailing address:
  • Phone: 501-553-5348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: