McKenzie Raquel McClelland, AG-ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704343121 Issued in MI

Practice address

940 Belmont St
Brockton, MA 02301-5596

Phone

(774) 826-1424

NPI assigned

Feb 20, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1073013645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAND",
        "first_name": "MCKENZIE",
        "middle_name": "RAQUEL",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP10809",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP10809",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704343121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Corliss McCarthy
• Pamela McCarthy, CRNA
• Philip Charles McCartin, LICSW
• Kayleigh Noelle McCarty, PHD
• Patricia McClean I, LICSW
• Mary McCoin
• Neena Nicole McConnico, M.A., LMHC
• Michael J McCoobery, MD
• Joseph R McCool, EDD
• Elaine M McCormack, LICSW

• Acute Care Nurse Practitioner in Brockton, MA
• Providers in Brockton, MA by specialty
• Acute Care Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.