Provider Demographics
NPI:1326269473
Name:MCCLURE, REBECCA S (RN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 VAN REED RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1799
Mailing Address - Country:US
Mailing Address - Phone:484-516-2937
Mailing Address - Fax:484-930-0229
Practice Address - Street 1:560 VAN REED RD STE 101
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1799
Practice Address - Country:US
Practice Address - Phone:484-516-2937
Practice Address - Fax:484-930-0229
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN254674L163WW0101X
PAUP004938G363LX0001X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAUP004938GMedicare UPIN