Provider Demographics
NPI:1720533136
Name:CLAIBORNE, REANNA CHALITA
Entity Type:Individual
Prefix:
First Name:REANNA
Middle Name:CHALITA
Last Name:CLAIBORNE
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 1:406 W MORRIS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-4150
Mailing Address - Country:US
Mailing Address - Phone:985-402-3698
Mailing Address - Fax:
Practice Address - Street 1:406 W MORRIS AVE STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-4150
Practice Address - Country:US
Practice Address - Phone:985-402-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator