Provider Demographics
NPI:1710284153
Name:EMESIBE, CLAIRE CHIOMA
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:CHIOMA
Last Name:EMESIBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 SHADOWBROOK TRL
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-7315
Mailing Address - Country:US
Mailing Address - Phone:615-578-2151
Mailing Address - Fax:615-641-7664
Practice Address - Street 1:4008 SHADOWBROOK TRL
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-7315
Practice Address - Country:US
Practice Address - Phone:615-578-2151
Practice Address - Fax:615-641-7664
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10000000008045251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10000000008045OtherPERSONAL SUPPORT SERVICES AGENCY