Provider Demographics
NPI:1568039196
Name:CLORES, CLORINDA AGUADA (AGNP-C)
Entity Type:Individual
Prefix:
First Name:CLORINDA
Middle Name:AGUADA
Last Name:CLORES
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 CHANDA LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5897
Mailing Address - Country:US
Mailing Address - Phone:615-828-9954
Mailing Address - Fax:
Practice Address - Street 1:3106 CHANDA LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-5897
Practice Address - Country:US
Practice Address - Phone:615-828-9954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27439363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty