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General NPI Number Information
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NPI Number | 1265030019
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Entity Type | Individual
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Provider Name | ANDREA A MCLEAN APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 1001 N RIVIAN MTWY
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City | BLOOMINGTON
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State | IL
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Zip | 61705-6424
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Country | US
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Telephone | 309-828-0806
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Fax | 309-827-5013
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Provider Business Mailing Address
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Address Line | 802 COUNTRY LN
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City | BLOOMINGTON
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State | IL
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Zip | 61704-6263
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Country | US
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Telephone | 309-530-5144
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.021682
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209021682
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License Number State | IL
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