Individual
REBECCA MCCLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
(269) 985-4632
Mailing address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
938607
TX
363L00000X
Nurse Practitioner
Primary
4704406707
MI
363LC0200X
Critical Care Medicine Nurse Practitioner
1029371
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029371
STATE LICENSE
TX
Enumeration date
11/08/2019
Last updated
04/02/2026
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