Provider Demographics
NPI:1801200555
Name:MCCLAIN, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCCLAIN
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 1:13740 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-4220
Mailing Address - Country:US
Mailing Address - Phone:216-355-7129
Mailing Address - Fax:
Practice Address - Street 1:13740 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-4220
Practice Address - Country:US
Practice Address - Phone:216-355-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH184411010403OtherBUCKEYE COMMUNITY HEALTH PLAN - MY CARE OHIO