Provider Demographics
NPI:1356833958
Name:MCLEAN, MEAGAN BRADHAM (DNP)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BRADHAM
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WALDEN RIDGE DR STE 10
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8592
Mailing Address - Country:US
Mailing Address - Phone:833-365-7246
Mailing Address - Fax:828-348-4971
Practice Address - Street 1:340 COMMERCE AVE STE 5
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7115
Practice Address - Country:US
Practice Address - Phone:833-365-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010544363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health