Provider Demographics
NPI:1588728232
Name:MCLEAN, GLENDA K (NP)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:K
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 EILEENS WAY
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9196
Mailing Address - Country:US
Mailing Address - Phone:302-477-3860
Mailing Address - Fax:302-477-3863
Practice Address - Street 1:2501 EBRIGHT RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-1125
Practice Address - Country:US
Practice Address - Phone:302-477-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ-0000193363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics