Individual
RENEE MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5450 FORT ST, EMERGENCY DEPT, TRENTON, MI 48183-4601
(734) 671-3883
(734) 467-5500
Mailing address
38935 ANN ARBOR RD, CREDENTIALING, LIVONIA, MI 48150-3397
(734) 805-0488
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704272615
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12646596
CAQH
MI
Enumeration date
01/03/2014
Last updated
02/07/2014
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