Individual
CAROL MCLENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
710 GENESIS BLVD, BRIDGEPORT, WV 26330-9668
(681) 342-3490
(681) 342-3491
Mailing address
527 MEDICAL PARK DR STE 400, BRIDGEPORT, WV 26330-9010
(681) 342-3490
(681) 342-3491
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
92122
WV
363LF0000X
Family Nurse Practitioner
92122
WV
Other
Enumeration date
08/14/2015
Last updated
10/27/2020
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