Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN55696-NNP-BC | WV |
NPI | 1164960415 |
---|---|
Provider Name | Ms. Keri Mclean |
First Address | Huntington, WV 25701-3804 |
Second Address | Huntington, WV 25701-3804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2017 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0250514 | (05) | OH |
1164960415 | (05) | WV |
7100512520 | (05) | KY |