Provider Demographics
NPI:1225131386
Name:CLAYTON, CORLISS MARIE (RN)
Entity Type:Individual
Prefix:
First Name:CORLISS
Middle Name:MARIE
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12463 ST MICHEL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015
Mailing Address - Country:US
Mailing Address - Phone:713-453-5208
Mailing Address - Fax:
Practice Address - Street 1:12463 SAINT MICHEL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-3346
Practice Address - Country:US
Practice Address - Phone:713-453-5208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234139163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult