Individual
AUTUMN MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1990 NW 21ST ST, MCMINNVILLE, OR 97128-6769
(503) 752-2838
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4393
(856) 694-5179
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201505014RN
OR
363L00000X
Nurse Practitioner
CNP251127
ME
363LF0000X
Family Nurse Practitioner
Primary
202107827NP-PP
OR
Other
Enumeration date
06/16/2021
Last updated
04/07/2026
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