Individual
THERESA B MACLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 2ND FLOOR TAUBMAN CENTER RECP E, ANN ARBOR, MI 48109-0330
(734) 936-7030
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704078150
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4626204
—
MI
Enumeration date
01/16/2007
Last updated
07/08/2007
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