Healthcare Provider Details

I. General information

NPI: 1548092224
Provider Name (Legal Business Name): CLAUDETTE DUFFUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2992 W MAIN ST
SNELLVILLE GA
30078-5764
US

IV. Provider business mailing address

3296 HIGHPOINT CT
SNELLVILLE GA
30078-7401
US

V. Phone/Fax

Practice location:
  • Phone: 478-988-0937
  • Fax: 585-502-1157
Mailing address:
  • Phone: 478-988-0937
  • Fax: 585-502-1157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: