Provider Demographics
NPI:1912707324
Name:MCLELLAN, TERESA E (BSN, RN, BCPA)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:E
Last Name:MCLELLAN
Suffix:
Gender:
Credentials:BSN, RN, BCPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 HIDDEN EDDY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-0087
Mailing Address - Country:US
Mailing Address - Phone:142-730-0912
Mailing Address - Fax:723-630-5569
Practice Address - Street 1:809 HIDDEN EDDY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-0087
Practice Address - Country:US
Practice Address - Phone:214-273-0091
Practice Address - Fax:972-363-0556
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX731714163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health