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Individual

MELISSA ANN MCCLEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2900 TELESTAR CT, FALLS CHURCH, VA 22042-1206
(703) 396-6194
(703) 779-1372
Mailing address
2900 TELESTAR CT, FALLS CHURCH, VA 22042-1206
(703) 396-6194
(703) 779-1372

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024169415
VA
363LA2200X
Adult Health Nurse Practitioner
0024169415
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024169415
LICENSE
VA
Enumeration date
06/13/2011
Last updated
07/09/2021
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