Provider Demographics
NPI:1477551109
Name:MCLEOD, WAYNE C (APRN-BC)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:C
Last Name:MCLEOD
Suffix:
Gender:M
Credentials:APRN-BC
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Other - First Name:
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Mailing Address - Street 1:6422 E SPEEDWAY BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1149
Mailing Address - Country:US
Mailing Address - Phone:520-318-3004
Mailing Address - Fax:520-318-3061
Practice Address - Street 1:6422 E SPEEDWAY BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1149
Practice Address - Country:US
Practice Address - Phone:520-318-3004
Practice Address - Fax:520-318-3061
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP2122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ41916Medicare UPIN
AZZ119672Medicare PIN