Individual
MISTY BROOKE MCCLELLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-9000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN239063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN239063
GA BON APRN LICENSE
GA
Enumeration date
07/13/2020
Last updated
06/02/2023
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