Provider Demographics
NPI:1457110165
Name:LLYOD, CLARA MILDRED
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:MILDRED
Last Name:LLYOD
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 1:257 POPLAR ST APT 14
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962-1295
Mailing Address - Country:US
Mailing Address - Phone:304-992-5652
Mailing Address - Fax:
Practice Address - Street 1:257 POPLAR ST APT 14
Practice Address - Street 2:
Practice Address - City:RAINELLE
Practice Address - State:WV
Practice Address - Zip Code:25962-1295
Practice Address - Country:US
Practice Address - Phone:304-992-5652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant