MEDICARE: MEREDITH L MCLERRAN APRN

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	APRN9272919	FL

General Provider Information

NPI Number	:	1669807145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH L MCLERRAN APRN

Provider Business Mailing Address
First Line	:	4507 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-2703
Country	:	US
Telephone Number	:	813-876-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4507 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-2703
Country	:	US
Telephone Number	:	813-876-4100
Fax Number	:

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

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	02/05/2020

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