Provider Demographics
NPI:1407060197
Name:YOUNG, CLARA DIANNE (RN)
Entity Type:Individual
Prefix:MR
First Name:CLARA
Middle Name:DIANNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:1085 CHESTUA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-7740
Mailing Address - Country:US
Mailing Address - Phone:423-420-1935
Mailing Address - Fax:423-420-1931
Practice Address - Street 1:MCMINN COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:393 COUNTY ROAD 554
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37371
Practice Address - Country:US
Practice Address - Phone:423-745-7431
Practice Address - Fax:423-744-1604
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNRN0000101202163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health