Provider Demographics
NPI:1689937534
Name:MCCLENDON, KAREN B (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:B
Last Name:MCCLENDON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:18205 HIGHWAY 1061
Mailing Address - Street 2:P.O. BOX 878
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-6245
Mailing Address - Country:US
Mailing Address - Phone:985-748-9704
Mailing Address - Fax:985-748-2029
Practice Address - Street 1:330 W OAK ST
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2720
Practice Address - Country:US
Practice Address - Phone:985-748-2025
Practice Address - Fax:985-748-2029
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN045412163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health