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General NPI Number Information
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NPI Number | 1821638479
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Entity Type | Individual
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Provider Name | SANDRA MCCLAIN
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Gender | Female
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Dates
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Enumeration Date | 01/12/2020
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 620 PARKER RD
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City | MAYSVILLE
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State | KY
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Zip | 41056-9620
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Country | US
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Telephone | 731-394-1145
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Fax |
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Provider Business Mailing Address
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Address Line | 385 COPPERAS HOLW
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City | MOREHEAD
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State | KY
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Zip | 40351-8295
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Country | US
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Telephone | 606-356-6935
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 3012944
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License Number State | KY
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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 | 3012944
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License Number State | KY
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