Provider Demographics
NPI:1790338143
Name:MACLEAN, CLARE LYNN (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:LYNN
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:LYNN
Other - Last Name:TYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3910
Mailing Address - Country:US
Mailing Address - Phone:248-385-0804
Mailing Address - Fax:248-385-0810
Practice Address - Street 1:50 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-3910
Practice Address - Country:US
Practice Address - Phone:248-385-0804
Practice Address - Fax:248-385-0810
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704286303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily