Annette D McClenahan, RN BSN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

9406121 Issued in FL

Practice address

12550 New Brittany Blvd
Fort Myers, FL 33907-3655

Phone

(239) 424-3120

NPI assigned

Jul 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1164735312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-424-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-424-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENAHAN",
        "first_name": "ANNETTE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "440921",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "9406121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna K McClain, PHARMD
• Scott Paul McClaran, D.M.D.
• Madison McClard
• Lori McClellan
• Rihannan M McClelland, BA
• Lemetrice Dewand McClendon, NP-C OR APRN
• Michael J. McCleod, DO
• Jocelin McCloud
• John Reed McClure
• Kristina Daniela McColgan, PA-C

• Diabetes Educator Registered Nurse in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Diabetes Educator Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.