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General NPI Number Information
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NPI Number | 1275409989
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Entity Type | Individual
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Provider Name | ASHLEY MARIE MCCLELLAN
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Gender | Female
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Dates
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Enumeration Date | 10/11/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 8178 JACKSON RD STE C
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City | ANN ARBOR
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State | MI
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Zip | 48103-9806
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Country | US
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Telephone | 734-802-1128
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Fax | 734-290-5860
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Provider Business Mailing Address
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Address Line | 9516 CHURCHILL RD
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City | JACKSON
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State | MI
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Zip | 49201-8244
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Country | US
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Telephone | 734-634-1732
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704325047
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License Number State | MI
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