Provider Demographics
NPI:1063144418
Name:MCLEAN, MICHAEL (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8852
Mailing Address - Country:US
Mailing Address - Phone:919-327-1630
Mailing Address - Fax:
Practice Address - Street 1:10950 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8852
Practice Address - Country:US
Practice Address - Phone:919-327-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF07211625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily