Provider Demographics
NPI:1720427560
Name:IGWACHO-ALLOTEY, CLARA A (RN, PMNP)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:A
Last Name:IGWACHO-ALLOTEY
Suffix:
Gender:F
Credentials:RN, PMNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 TORREY PINES TER
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1161
Mailing Address - Country:US
Mailing Address - Phone:240-644-9706
Mailing Address - Fax:
Practice Address - Street 1:13321 NEW HAMPSHIRE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-3450
Practice Address - Country:US
Practice Address - Phone:240-644-9706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3368P251E00000X, 251F00000X, 251G00000X
MDR139080163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based