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Individual

MRS. SHELLIANN MARIE ENDLINE-MCCLARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
770 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-8602
(616) 272-3533
(616) 259-4839
Mailing address
801 ROSEHILL RD, JACKSON, MI 49202-1762
(615) 627-2293

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704176891
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4560345 10
MI
01
50-0-87-0197-0
BCBSM PC
MI
Enumeration date
01/09/2007
Last updated
05/02/2025
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