Provider Demographics
NPI:1982978847
Name:MCCLANAHAN, JAMES THOMAS (CRNFA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:MCCLANAHAN
Suffix:
Gender:M
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 MOUNT VERNON LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2885
Mailing Address - Country:US
Mailing Address - Phone:615-243-0583
Mailing Address - Fax:
Practice Address - Street 1:1158 MOUNT VERNON LN
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-2885
Practice Address - Country:US
Practice Address - Phone:615-243-0583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN115409163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant