Provider Demographics
NPI:1477093391
Name:MCCLAIN, PAULETTE (DNP, APRN, A-GNP-C)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:DNP, APRN, A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8786 GOODWOOD BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7917
Mailing Address - Country:US
Mailing Address - Phone:225-229-6356
Mailing Address - Fax:833-913-2021
Practice Address - Street 1:761 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6512
Practice Address - Country:US
Practice Address - Phone:225-305-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2022-04-16
Deactivation Date:2021-01-21
Deactivation Code:
Reactivation Date:2021-02-10
Provider Licenses
StateLicense IDTaxonomies
LAAP09212363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care