MEDICARE: MS. KAREN M MCLANE FNP-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	363LF0000X	Family Nurse Practitioner	900	AK

General Provider Information

NPI Number	:	1417920075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN M MCLANE FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 548
Second Line	:	IHS SELLS SERVICE UNIT
City	:	SELLS
State	:	AZ
Zip	:	85634-0548
Country	:	US
Telephone Number	:	520-383-6800
Fax Number	:	520-383-0700

Provider Business Practice Location Address
First Line	:	HIGHWAY 86 AND TOPAWA ROAD
Second Line	:	IHS SELLS SERVICE UNIT
City	:	SELLS
State	:	AZ
Zip	:	85634-0548
Country	:	US
Telephone Number	:	520-383-6800
Fax Number	:	520-383-0700

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	03/11/2013

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