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NPI Code Detail

MEDICARE: JENNIE M. MCCLAIN RN,DNP, FNP-BC

MEDICARE: JENNIE M. MCCLAIN RN,DNP, 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
1363LF0000XFamily Nurse Practitioner28108786AIN

General Provider Information

NPI Number : 1588812010
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIE M. MCCLAIN RN,DNP, FNP-BC
Provider Business Mailing Address
First Line : 207 W HIGH ST
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-2427
Country : US
Telephone Number : 740-392-1181
Fax Number : 740-392-1180
Provider Business Practice Location Address
First Line : 207 W HIGH ST
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-2427
Country : US
Telephone Number : 740-392-1181
Fax Number : 740-392-1180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2008
Last Update Date : 12/09/2015

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