MEDICARE: VIRGINIA ANN MCLEAN CPNP

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	363L00000X	Nurse Practitioner	136951	NC
2	363LP0200X	Pediatric Nurse Practitioner	136951	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417141052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA ANN MCLEAN CPNP

Provider Business Mailing Address
First Line	:	401 IRVING PKWY STE 230
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-5301
Country	:	US
Telephone Number	:	919-385-8850
Fax Number	:	919-385-8874

Provider Business Practice Location Address
First Line	:	401 IRVING PKWY STE 230
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-5301
Country	:	US
Telephone Number	:	919-385-8850
Fax Number	:	919-385-8874

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

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	03/28/2024

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