Healthcare Provider Details

I. General information

NPI: 1487501516
Provider Name (Legal Business Name): JAKEEMA MCCLOUD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6828 MATTHEWS MINT HILL RD
MINT HILL NC
28227-9489
US

IV. Provider business mailing address

334 KELFORD LN
CHARLOTTE NC
28270-2200
US

V. Phone/Fax

Practice location:
  • Phone: 704-424-5017
  • Fax:
Mailing address:
  • Phone: 984-227-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34468
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: