Provider Demographics
NPI:1982361655
Name:MCCLAIN, KARI (NP)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:MCCLAIN
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 1:56120 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-8923
Mailing Address - Country:US
Mailing Address - Phone:574-528-1557
Mailing Address - Fax:
Practice Address - Street 1:56120 SHADY LN
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-8923
Practice Address - Country:US
Practice Address - Phone:574-528-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2020037523363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care