MEDICARE: JACQUELINE MCLEAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	28141117A	IN

General Provider Information

NPI Number	:	1205789039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE MCLEAN

Provider Business Mailing Address
First Line	:	705 RAINBOW LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-4613
Country	:	US
Telephone Number	:	317-833-6985
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 RAINBOW LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-4613
Country	:	US
Telephone Number	:	317-833-6985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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Directions to “ JACQUELINE MCLEAN ” Practice Location

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