Provider Demographics
NPI:1912750258
Name:MCCLINTON, YOLANDA M (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:M
Last Name:MCCLINTON
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 COMANCHE RUN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5647
Mailing Address - Country:US
Mailing Address - Phone:615-919-2123
Mailing Address - Fax:
Practice Address - Street 1:1716 COMANCHE RUN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5647
Practice Address - Country:US
Practice Address - Phone:615-919-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide