Provider Demographics
NPI:1144671603
Name:CLAYTON, PAULETTE (CNA)
Entity type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4884 CRANSTON CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3178
Mailing Address - Country:US
Mailing Address - Phone:240-435-0121
Mailing Address - Fax:202-635-5756
Practice Address - Street 1:1731 BUNKER HILL ROAD, NE
Practice Address - Street 2:HSC HOME CARE, LLC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-635-5756
Practice Address - Fax:202-635-5780
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00058707374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide