Provider Demographics
NPI:1487019170
Name:MCCLUNE, JANICE RENA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:RENA
Last Name:MCCLUNE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 COLLEGE AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3372
Mailing Address - Country:US
Mailing Address - Phone:717-735-3738
Mailing Address - Fax:717-735-3736
Practice Address - Street 1:2221 NOLL DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7610
Practice Address - Country:US
Practice Address - Phone:717-715-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015491363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner