Provider Demographics
NPI:1265423347
Name:MCLEAN, JOAN A (APN)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:A
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-7424
Mailing Address - Country:US
Mailing Address - Phone:870-777-0007
Mailing Address - Fax:870-777-0061
Practice Address - Street 1:104 E 16TH ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-7424
Practice Address - Country:US
Practice Address - Phone:870-777-0007
Practice Address - Fax:870-777-0061
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01251 ANP164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00194875OtherPALAMETTO RETIRED RAILROA
AR5C874OtherARKANSAS BCBS
AR5T414Medicare ID - Type Unspecified