Provider Demographics
NPI:1326749326
Name:MCCLANE, NNEKA (CRNP)
Entity Type:Individual
Prefix:
First Name:NNEKA
Middle Name:
Last Name:MCCLANE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:NNEKA
Other - Middle Name:
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1521B CARLISLE PIKE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-8816
Mailing Address - Country:US
Mailing Address - Phone:410-701-8070
Mailing Address - Fax:
Practice Address - Street 1:401 E MURPHY AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-2700
Practice Address - Country:US
Practice Address - Phone:724-628-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235392363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health