| NPI | 1407136732 |
|---|---|
| Former Name | AMY R MCCLELLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R183603) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011556) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2023-11-08 |