Provider Demographics
NPI:1427386168
Name:MCCLOSKEY, CARLEY LEE (NP)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:LEE
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4976 ALPHA LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5470
Mailing Address - Country:US
Mailing Address - Phone:423-308-0280
Mailing Address - Fax:423-308-0281
Practice Address - Street 1:2051 HAMILL RD
Practice Address - Street 2:STE 204
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4653
Practice Address - Country:US
Practice Address - Phone:423-870-2450
Practice Address - Fax:423-877-5208
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14562363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health