Provider Demographics
NPI:1881436988
Name:MCLENNAN, CRISTINA MARIE
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:MCLENNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 S 1000 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-3618
Mailing Address - Country:US
Mailing Address - Phone:760-415-3062
Mailing Address - Fax:
Practice Address - Street 1:732 S 1000 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-3618
Practice Address - Country:US
Practice Address - Phone:760-415-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay