Provider Demographics
NPI:1801026075
Name:MCCLENDON, NEKITTA NICOLE
Entity Type:Individual
Prefix:
First Name:NEKITTA
Middle Name:NICOLE
Last Name:MCCLENDON
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 1:412 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1624
Mailing Address - Country:US
Mailing Address - Phone:317-213-3734
Mailing Address - Fax:317-926-1316
Practice Address - Street 1:412 E 21ST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1624
Practice Address - Country:US
Practice Address - Phone:317-213-3734
Practice Address - Fax:317-926-1316
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker