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NPI Code Detail

MEDICARE: MRS. DEANN MARIE MCCLELLAN

MEDICARE:  MRS. DEANN MARIE MCCLELLAN
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
1363LF0000XFamily Nurse Practitioner113250NE
2363LW0102XWomen's Health Nurse Practitioner113250NE

General Provider Information

NPI Number : 1508476847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEANN MARIE MCCLELLAN
Provider Business Mailing Address
First Line : PO BOX 1210
Second Line :
City : KEARNEY
State : NE
Zip : 68848-1210
Country : US
Telephone Number : 308-865-2740
Fax Number :
Provider Business Practice Location Address
First Line : 3500 CENTRAL AVE STE A
Second Line :
City : KEARNEY
State : NE
Zip : 68847-2963
Country : US
Telephone Number : 308-865-2740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2020
Last Update Date : 04/22/2026

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Directions to “ MRS. DEANN MARIE MCCLELLAN ” Practice Location

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