MEDICARE: JENNIFER L MCCLEARY ANP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	4704198828	MI

General Provider Information

NPI Number	:	1417201138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L MCCLEARY ANP-BC

Provider Business Mailing Address
First Line	:	2845 CAPITAL AVE SW STE 206
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-4186
Country	:	US
Telephone Number	:	269-962-0790
Fax Number	:	269-962-0828

Provider Business Practice Location Address
First Line	:	2845 CAPITAL AVE SW STE 206
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-4186
Country	:	US
Telephone Number	:	269-962-0790
Fax Number	:	269-962-0828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2012
Last Update Date	:	04/07/2026

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