Individual
MARYANNE KATHLEEN MCCLANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2100 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-5128
(505) 265-1711
Mailing address
2100 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-5128
(505) 265-1711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L19926
NM
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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