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Individual

MCKENZIE RAQUEL MCCLELLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AG-ACNP

Contact information

Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-1424
Mailing address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-1424

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704343121
MI
363LA2100X
Acute Care Nurse Practitioner
AP10809
AZ
363LA2200X
Adult Health Nurse Practitioner
AP10809
AZ

Other

Enumeration date
02/20/2018
Last updated
06/16/2023
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