Provider Demographics
NPI:1982043493
Name:HIMES, CLAYTON (ACNP, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:
Last Name:HIMES
Suffix:
Gender:M
Credentials:ACNP, FNP-C
Other - Prefix:
Other - First Name:CLAY
Other - Middle Name:
Other - Last Name:HIMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5513 SAINT ELMO AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37409-2312
Mailing Address - Country:US
Mailing Address - Phone:615-400-5959
Mailing Address - Fax:
Practice Address - Street 1:210 WESTWOOD PL STE 110
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7554
Practice Address - Country:US
Practice Address - Phone:615-206-2462
Practice Address - Fax:833-983-2043
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN177179163W00000X
TN17258363LA2100X
FLARNP9418956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care