Provider Demographics
NPI:1447876941
Name:CLAYBROOK, ARIS MONIQUE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ARIS
Middle Name:MONIQUE
Last Name:CLAYBROOK
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 ISABELLE AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-4224
Mailing Address - Country:US
Mailing Address - Phone:262-488-5734
Mailing Address - Fax:
Practice Address - Street 1:310 5TH ST STE 101B
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-4605
Practice Address - Country:US
Practice Address - Phone:262-488-5734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI178133-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse