Mcclellan, Mary M

Mcclellan, Mary M is an individual health care provider with primary practice located at 2000 Boise Ave , Loveland CO 80538-5006. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Mcclellan, Mary M can be contacted via phone (970) 669-4640.

Contact Information

Primary practice address
2000 Boise Ave Loveland CO 80538-5006
Phone: (970) 669-4640
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 62279 Colorado

Profile Details

NPI number 1497746879
LBN Legal business name Mcclellan, Mary M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Jan 4th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497746879 NPPES
Colorado MEDICAID 36832375

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