Provider Demographics
NPI:1114119237
Name:MCCLELLAN, DON L (RN)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:L
Last Name:MCCLELLAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6200 W BLUEMOUND RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-4145
Mailing Address - Country:US
Mailing Address - Phone:414-771-5600
Mailing Address - Fax:414-476-9988
Practice Address - Street 1:6200 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53213-4145
Practice Address - Country:US
Practice Address - Phone:414-771-5600
Practice Address - Fax:414-476-9988
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator