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General NPI Number Information
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NPI Number | 1982043493
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Entity Type | Individual
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Provider Name | CLAYTON HIMES ACNP, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 210 WESTWOOD PL STE 110
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City | BRENTWOOD
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State | TN
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Zip | 37027-7554
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Country | US
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Telephone | 615-206-2462
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Fax | 833-983-2043
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Provider Business Mailing Address
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Address Line | 5513 SAINT ELMO AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37409-2312
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Country | US
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Telephone | 615-400-5959
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 177179
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 17258
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9418956
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License Number State | FL
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