Provider Demographics
NPI:1538459433
Name:MACLEAN, VICKI (RNP)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NEW CROSSING RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3270
Mailing Address - Country:US
Mailing Address - Phone:781-246-3500
Mailing Address - Fax:781-246-3555
Practice Address - Street 1:30 NEW CROSSING RD
Practice Address - Street 2:SUITE 207
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3270
Practice Address - Country:US
Practice Address - Phone:781-246-3500
Practice Address - Fax:781-246-3555
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN140031363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily