Individual
BERNICE MCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1 TALLOW WOOD DR, SUITE 2, CLIFTON PARK, NY 12065-2807
(518) 373-4555
(518) 371-3839
Mailing address
PO BOX 689, TROY, NY 12181-0689
(518) 268-5000
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
000177
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01213496
—
NY
Enumeration date
05/01/2006
Last updated
05/21/2008
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