Provider Demographics
NPI:1669931283
Name:MCLELLAN, KAREN J (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:MCLELLAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 HOMELAND RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-5802
Mailing Address - Country:US
Mailing Address - Phone:954-410-0813
Mailing Address - Fax:561-333-1858
Practice Address - Street 1:6111 HOMELAND RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449-5802
Practice Address - Country:US
Practice Address - Phone:954-410-0813
Practice Address - Fax:561-333-1858
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily