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General NPI Number Information
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NPI Number | 1386003358
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Entity Type | Individual
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Provider Name | CARLEY MCCLOUD NP
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Gender | Female
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 4350 7TH ST
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City | MOLINE
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State | IL
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Zip | 61265-6870
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Country | US
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Telephone | 309-517-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 402 E 4TH ST APT 105
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City | DAVENPORT
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State | IA
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Zip | 52801-1753
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Country | US
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Telephone | 314-560-5711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.014836
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RN2298925
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 2015038431
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2016028855
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License Number State | MO
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