Healthcare Provider Details

I. General information

NPI: 1740647585
Provider Name (Legal Business Name): KAY MCLEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2016
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTURY PARK S SUITE 214
BIRMINGHAM AL
35226-3949
US

IV. Provider business mailing address

100 CENTURY PARK S SUITE 214
BIRMINGHAM AL
35226-3949
US

V. Phone/Fax

Practice location:
  • Phone: 205-978-7840
  • Fax: 205-978-7847
Mailing address:
  • Phone: 205-978-7840
  • Fax: 205-978-7847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number1017199
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: