MEDICARE: KAY MCLEAN

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	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	1017199	AL

General Provider Information

NPI Number	:	1740647585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY MCLEAN

Provider Business Mailing Address
First Line	:	100 CENTURY PARK S
Second Line	:	SUITE 214
City	:	BIRMINGHAM
State	:	AL
Zip	:	35226-3949
Country	:	US
Telephone Number	:	205-978-7840
Fax Number	:	205-978-7847

Provider Business Practice Location Address
First Line	:	100 CENTURY PARK S
Second Line	:	SUITE 214
City	:	BIRMINGHAM
State	:	AL
Zip	:	35226-3949
Country	:	US
Telephone Number	:	205-978-7840
Fax Number	:	205-978-7847

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

Provider Enumeration Date	:	01/25/2016
Last Update Date	:	01/25/2016

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Directions to “ KAY MCLEAN ” Practice Location

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