Healthcare Provider Details

I. General information

NPI: 1144671603
Provider Name (Legal Business Name): PAULETTE CLAYTON CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 BUNKER HILL ROAD, NE HSC HOME CARE, LLC
WASHINGTON DC
20017
US

IV. Provider business mailing address

4884 CRANSTON CT
WALDORF MD
20602-3178
US

V. Phone/Fax

Practice location:
  • Phone: 202-635-5756
  • Fax: 202-635-5780
Mailing address:
  • Phone: 240-435-0121
  • Fax: 202-635-5756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA00058707
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: