Individual
CARLEY MCCLOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4350 7TH ST, MOLINE, IL 61265-6870
(309) 517-1180
Mailing address
402 E 4TH ST, APT 105, DAVENPORT, IA 52801-1753
(314) 560-5711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2016028855
MO
363L00000X
Nurse Practitioner
Primary
209.014836
IL
390200000X
Student in an Organized Health Care Education/Training Program
2015038431
MO
390200000X
Student in an Organized Health Care Education/Training Program
RN2298925
MA
Other
Enumeration date
02/18/2016
Last updated
10/12/2016
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