Nicole R McClanahan
Individual provider Active NPI Other Technician · Pollock Pines, CA
NPI 1508450768 · NPPES record last updated Feb 26, 2021
Key facts
- NPI
- 1508450768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 2804 Romer Blvd
Pollock Pines, CA 95726-9242 - Phone
- (855) 832-6727
- NPI assigned
- Feb 26, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
2804 Romer Blvd
Pollock Pines, CA 95726-9242
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Other names
- Nicole R Eckerman
Other providers in Pollock Pines, CA
- Kiara Yong Lofton
- Longs Drug Stores California LLC
- Tracy Lopez
- Isabella Marquez
- Diana Lynn McCann
- Katherine Melnikov
- Deborah Ann Metoyer-Spieth
- Jay H Miser
- Timothy Hyun Moon
- Mountain Lake Medical GRP PC
All providers in Pollock Pines, CA · Other Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2021. 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.