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General NPI Number Information
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NPI Number | 1609185305
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Entity Type | Individual
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Provider Name | MARYLOU MCCLELLAND RN
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Gender | Female
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 515 SHOSHONE CIR
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City | ELKO
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State | NV
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Zip | 89801-5072
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Country | US
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Telephone | 775-748-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 271 GREENCREST DR
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City | SPRING CREEK
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State | NV
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Zip | 89815-5447
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Country | US
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Telephone | 775-753-4708
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN55312
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License Number State | NV
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