Individual
SHANTA LACOLE CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
127 ROWLAND DR UNIT C, MOULTRIE, GA 31768-4120
(229) 891-3198
(229) 616-4224
Mailing address
127 ROWLAND DR UNIT C, MOULTRIE, GA 31768-4120
(229) 891-3198
(229) 616-4224
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN251414
GA
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN251414
GA
Other
Enumeration date
02/20/2018
Last updated
03/04/2026
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