Wanda Renee McClellan, APN
Individual provider Active NPI Primary Care Nurse Practitioner · Hampton, AR
NPI 1124224746 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124224746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- A01769 (AR)
- Practice address
- 402 South Lee Street
Hampton, AR 71744-0851 - Phone
- (870) 798-4299
- Fax
- (870) 798-2005
- NPI assigned
- Jun 21, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A01769 | AR | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cabun Rural Health Services, Inc | Past | Accepting new patients | |
| Cabun Rural Health Services, Inc. | Past | Accepting new patients | |
| HMV Diagnostics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | A01769 | AR | Yes |
Addresses
Primary practice location
402 South Lee Street
Hampton, AR 71744-0851
Mailing address
PO Box 851
Hampton, AR 71744-0851
Phone (870) 798-4299
Other providers in Hampton, AR
- Hampton Medical Pharmacy
- Aubree Haynes
- Sydney Jeans
- Darla J Johnston
- Charles Lee Liggett Jr.
- Pendulum Health Systems
- Robert Todd Pennington
- Rhonda Seat
- South Arkansas Regional Health Center
- State of Arkansas
All providers in Hampton, AR · Primary Care Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.