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NPI Code Detail

MEDICARE: CONNOR ROSS MCCLELLAN

MEDICARE: CONNOR ROSS 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
1163W00000XRegistered NurseRN671142PA

General Provider Information

NPI Number : 1518503606
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNOR ROSS MCCLELLAN
Provider Business Mailing Address
First Line : 11 MELBA PL APT 7
Second Line :
City : PITTSBURGH
State : PA
Zip : 15213-4141
Country : US
Telephone Number : 412-719-3171
Fax Number :
Provider Business Practice Location Address
First Line : 3500 VICTORIA ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15213-2543
Country : US
Telephone Number : 412-624-4860
Fax Number : 412-624-1508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2019
Last Update Date : 11/23/2019

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Directions to “ CONNOR ROSS MCCLELLAN ” Practice Location

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