Individual
MRS. TINA MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2001 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2414
(952) 993-8000
Mailing address
8170 33RD AVE S, PO BOX 1309 MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R138246-8
MN
363LF0000X
Family Nurse Practitioner
Primary
2005005527
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D85063
MHI PROVIDER NUMBER
MN
Enumeration date
06/04/2006
Last updated
05/12/2016
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