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General NPI Number Information
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NPI Number | 1962107128
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Entity Type | Individual
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Provider Name | ALEXANDRA MARIE MCCLELLAN NP
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Gender | Female
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 161 CECIL B MOORE AVE APT 204
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City | PHILADELPHIA
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State | PA
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Zip | 19122-3243
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Country | US
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Telephone | 215-585-2144
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Fax | 267-780-7032
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Provider Business Mailing Address
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Address Line | 228 PARK AVE S STE 15314
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City | NEW YORK
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State | NY
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Zip | 10003-1502
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Country | US
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Telephone | 866-306-2026
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Fax | 833-228-5591
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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 | RN725016
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP027718
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | L8-0010697
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License Number State | DE
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