Provider Demographics
NPI:1467706341
Name:MCCLOUD, TANYA ANTOINETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ANTOINETTE
Last Name:MCCLOUD
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Gender:F
Credentials:RN
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Mailing Address - Street 1:2932 BREEZEWOOD AVE SUITE 1
Mailing Address - Street 2:ALL CARE HEALTHCARE SERVICES
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-5455
Mailing Address - Country:US
Mailing Address - Phone:910-867-2249
Mailing Address - Fax:910-867-7845
Practice Address - Street 1:2932 BREEZEWOOD AVE SUITE 102
Practice Address - Street 2:ALL CARE HEALTHCARE SERVICE
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-5455
Practice Address - Country:US
Practice Address - Phone:910-867-2249
Practice Address - Fax:910-867-7845
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
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Provider Licenses
StateLicense IDTaxonomies
NC217813163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse