MEDICARE: KATHRYN CLAYTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN.18439RX	SC
2	363LF0000X	Family Nurse Practitioner	AP127573	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962830885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN CLAYTON

Provider Business Mailing Address
First Line	:	11725 FM 620 N
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1348
Country	:	US
Telephone Number	:	512-996-8660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1172 FM 620 N
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1348
Country	:	US
Telephone Number	:	512-996-8660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2013
Last Update Date	:	05/05/2015

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Directions to “ KATHRYN CLAYTON ” Practice Location

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