Provider Demographics
NPI:1306202064
Name:MCCLAVE, MEGAN ROSE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ROSE
Last Name:MCCLAVE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 E ALTAMONTE DR STE 224
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4832
Mailing Address - Country:US
Mailing Address - Phone:407-830-9000
Mailing Address - Fax:407-830-9040
Practice Address - Street 1:661 E ALTAMONTE DR STE 224
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4832
Practice Address - Country:US
Practice Address - Phone:407-830-9000
Practice Address - Fax:407-830-9040
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN240228163W00000X
FL9456068363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN7863OtherFL HF MEDICARE