Mary Dana Overall McClellan, RN
Individual provider Active NPI Medical-Surgical Registered Nurse · Simpsonville, KY
NPI 1700660883 · NPPES record last updated Aug 21, 2023
Key facts
- NPI
- 1700660883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical-Surgical Registered Nurse 163WM0705X
- License
- 1099640 (KY)
- Practice address
- 220 Lakeshore Dr
Simpsonville, KY 40067-6649 - Phone
- (502) 319-3282
- NPI assigned
- Aug 21, 2023
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1099640 | KY | MD | Medical-Surgical Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 1099640 | KY | Yes |
Addresses
Primary practice location
220 Lakeshore Dr
Simpsonville, KY 40067-6649
Mailing address
220 Lakeshore Dr
Simpsonville, KY 40067-6649
Phone (502) 319-3282
Other providers in Simpsonville, KY
- Ronald McClish
- Tonya Miller
- Mortenson Family Dental Center - Simpsonville, PLLC
- North Central District Health Dept
- Kerrin Omer
- Parker Bowling, LLC
- Carolyn Pike
- Harold R Raleigh
- Barbara Michelle Ritchey
- Servant Hearts LLC
All providers in Simpsonville, KY · Medical-Surgical Registered Nurse in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2023. 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.