Provider Demographics
NPI:1861165409
Name:MCCLEARY, ANN LOUISE (CRNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LOUISE
Last Name:MCCLEARY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2651 PALESTINE RD
Mailing Address - Street 2:
Mailing Address - City:MORRISDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16858-8036
Mailing Address - Country:US
Mailing Address - Phone:814-360-8238
Mailing Address - Fax:
Practice Address - Street 1:2651 PALESTINE RD
Practice Address - Street 2:
Practice Address - City:MORRISDALE
Practice Address - State:PA
Practice Address - Zip Code:16858-8036
Practice Address - Country:US
Practice Address - Phone:814-360-8238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA645315163W00000X
PASP024069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse