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General NPI Number Information
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NPI Number | 1811780273
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Entity Type | Individual
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Provider Name | MICHELE LYNN CLEARY CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 7704 MATAPEAKE BUSINESS DR STE 200
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City | BRANDYWINE
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State | MD
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Zip | 20613-3045
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Country | US
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Telephone | 410-610-6763
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Fax |
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Provider Business Mailing Address
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Address Line | 11209 LAKESIDE DR
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City | DUNKIRK
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State | MD
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Zip | 20754-9418
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Country | US
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Telephone | 410-610-6763
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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 | R118530
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License Number State | MD
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