Provider Demographics
NPI:1811334683
Name:MCCLARY, NANCY SMALL (RN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SMALL
Last Name:MCCLARY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-2123
Mailing Address - Country:US
Mailing Address - Phone:843-355-7233
Mailing Address - Fax:843-355-9371
Practice Address - Street 1:1503 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-2123
Practice Address - Country:US
Practice Address - Phone:843-355-7233
Practice Address - Fax:843-355-9371
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43839163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool