MEDICARE: MRS. WHITNEY CLARIDY CLAYTON CRNP

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	1-150999	AL

General Provider Information

NPI Number	:	1982377016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WHITNEY CLARIDY CLAYTON CRNP

Provider Business Mailing Address
First Line	:	24020 JOHN T REID PKWY
Second Line	:
City	:	SCOTTSBORO
State	:	AL
Zip	:	35768-2855
Country	:	US
Telephone Number	:	256-594-8181
Fax Number	:

Provider Business Practice Location Address
First Line	:	24020 JOHN T REID PKWY
Second Line	:
City	:	SCOTTSBORO
State	:	AL
Zip	:	35768-2855
Country	:	US
Telephone Number	:	256-594-8181
Fax Number	:

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

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	12/10/2021

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