Provider Demographics
NPI:1689432114
Name:MCCLAIN, AMBER (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:PENNVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47369-0075
Mailing Address - Country:US
Mailing Address - Phone:260-615-1402
Mailing Address - Fax:
Practice Address - Street 1:201 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:MARKLE
Practice Address - State:IN
Practice Address - Zip Code:46770-9068
Practice Address - Country:US
Practice Address - Phone:260-758-2156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF12230732363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily