Individual
TARA M MACLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
3925 N GATEWAY DR, APPLETON, WI 54913-7863
(920) 225-1467
Mailing address
114 KLOMPEN CT, NEENAH, WI 54956-4341
(920) 901-0151
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13125-33
WI
363L00000X
Nurse Practitioner
Primary
13125-33
WI
363LF0000X
Family Nurse Practitioner
13125-33
WI
Other
Enumeration date
09/07/2022
Last updated
06/25/2025
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