Individual
NICHOLAS CHARLES MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5000
Mailing address
15016 PETELER LN, MINNETONKA, MN 55345-5740
(612) 237-1167
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11097
MN
Other
Enumeration date
12/12/2023
Last updated
12/13/2023
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