Individual
MELISSA A MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2357 108TH LN NE, MN002, BLAINE, MN 55449-5222
(763) 232-0323
Mailing address
2357 108TH LN NE, MN002, BLAINE, MN 55449-5222
(763) 232-0323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0605160
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-21788
MEDICA
MN
05
—
265443100
—
MN
01
—
283P8MC
BLUE CROSS BLUE SHIELD
MN
01
—
P00320152
MEDICARE RAILROAD
MN
Enumeration date
07/18/2006
Last updated
12/10/2024
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