Basic Information
| Provider Information | |||||||||
| NPI: | 1063710044 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLEAN | ||||||||
| FirstName: | ALLISON | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 91 TIMBERLANE RD | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287867927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284541098 | ||||||||
| FaxNumber: | 8667623954 | ||||||||
| Practice Location | |||||||||
| Address1: | 91 TIMBERLANE RD | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287867927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284541098 | ||||||||
| FaxNumber: | 8667623954 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2011 | ||||||||
| LastUpdateDate: | 08/06/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 5005080 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 7004732 | 05 | NC | MEDICAID |