Provider Demographics
NPI:1043702988
Name:MCCLATCHIE, KATLYNN KAYLA
Entity Type:Individual
Prefix:
First Name:KATLYNN
Middle Name:KAYLA
Last Name:MCCLATCHIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 SUTHERLAND AVE BLDG B
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-2355
Mailing Address - Country:US
Mailing Address - Phone:865-558-9040
Mailing Address - Fax:
Practice Address - Street 1:2455 SUTHERLAND AVE BLDG B
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2355
Practice Address - Country:US
Practice Address - Phone:865-558-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator