MEDICARE: DR. LISA QUINN MCCLEAN M.D.

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	RN1006237	DC

General Provider Information

NPI Number	:	1427197128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA QUINN MCCLEAN M.D.

Provider Business Mailing Address
First Line	:	3020 14TH ST NW
Second Line	:	SUITE 402B
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6865
Country	:	US
Telephone Number	:	202-745-4300
Fax Number	:	202-462-3428

Provider Business Practice Location Address
First Line	:	1638 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-4706
Country	:	US
Telephone Number	:	202-610-3880
Fax Number	:	202-610-0555

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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