Provider Demographics
NPI:1265222533
Name:MCCLANTOC, JOSSANE
Entity type:Individual
Prefix:
First Name:JOSSANE
Middle Name:
Last Name:MCCLANTOC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOSSANE
Other - Middle Name:KEMOYA
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 36258
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1204
Mailing Address - Country:US
Mailing Address - Phone:251-318-2678
Mailing Address - Fax:251-405-9900
Practice Address - Street 1:2451 UNIVERSITY HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2300
Practice Address - Country:US
Practice Address - Phone:251-471-7870
Practice Address - Fax:251-460-7923
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-160259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily