Provider Demographics
NPI:1023864774
Name:CLAYBORN, MARGARET A (COMMUNITY HEALTH)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:CLAYBORN
Suffix:
Gender:F
Credentials:COMMUNITY HEALTH
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:CLAYBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COMMUNITY HEALTH WOR
Mailing Address - Street 1:133 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-4409
Mailing Address - Country:US
Mailing Address - Phone:269-408-2258
Mailing Address - Fax:989-325-6435
Practice Address - Street 1:133 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-4409
Practice Address - Country:US
Practice Address - Phone:269-408-2258
Practice Address - Fax:989-325-6435
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
MI374U00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty