Tatanisha Monique Mcclary | Rochester, NY • PECOS Search

Tatanisha Monique Mcclary

Licensed Practical Nurse

Nursing Service Providers

57 Arbutus St Apt 2, Rochester, NY 14609-3501

PECOS Enrollment

Based on the most recent information from CMS, provider Tatanisha Monique Mcclary does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:33 PM.

Profile Details

Provider ID
1275095861
Provider Type
Individual
Full Name
Mcclary, Tatanisha Monique
Credential
LPN

Gender
Female
Sole Proprietor
No
Enumeration Date
4/2/2019
Last Updated
4/2/2019

Contact Information

Practice Location

57 Arbutus St Apt 2, Rochester, NY 14609-3501

Unlisted Fax

Mailing Location

57 Arbutus St Apt 2, Rochester, NY 14609-3501

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 164W00000X Primary	Description Licensed Practical Nurse Nursing Service Providers	License 331855-1 New York