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General NPI Number Information
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NPI Number | 1417201138
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Entity Type | Individual
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Provider Name | JENNIFER L MCCLEARY ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 11177 MICHIGAN AVE E
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City | BATTLE CREEK
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State | MI
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Zip | 49014-8904
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Country | US
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Telephone | 269-660-5782
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Fax | 269-660-5793
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Provider Business Mailing Address
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Address Line | 8645 WOLF RD
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City | BELLEVUE
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State | MI
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Zip | 49021-9605
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Country | US
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Telephone | 269-240-6110
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704198828
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License Number State | MI
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