Provider Demographics
NPI:1710482864
Name:PAULSON, CLARA ALINE (RN)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:ALINE
Last Name:PAULSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:ALINE
Other - Last Name:OSWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1923 SULPHUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-5654
Mailing Address - Country:US
Mailing Address - Phone:423-317-9344
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:2574 FRAYSER BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-5829
Practice Address - Country:US
Practice Address - Phone:901-302-4361
Practice Address - Fax:865-342-0121
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN73988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse