Provider Demographics
NPI:1235272873
Name:MCLAIN, JANE ANN (APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:211 SAINT FRANCIS DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5049
Practice Address - Country:US
Practice Address - Phone:573-331-5770
Practice Address - Fax:573-331-3974
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO110795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO423982701Medicaid
MO151178OtherBLUE CROSS BLUE SHIELD
MO151178OtherBLUE CROSS BLUE SHIELD