Provider Demographics
NPI:1396441978
Name:MCCLAIN, MAUREEN (APRN)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6651 N MILITARY TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2402
Mailing Address - Country:US
Mailing Address - Phone:561-988-3747
Mailing Address - Fax:
Practice Address - Street 1:6651 N MILITARY TRL STE 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2402
Practice Address - Country:US
Practice Address - Phone:561-988-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily