Provider Demographics
NPI:1457842692
Name:MCCLURE, MADYLENE KATHLEEN (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MADYLENE
Middle Name:KATHLEEN
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:MADYLENE
Other - Middle Name:KATHLEEN
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8765 N AMBASSADOR DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-2540
Mailing Address - Country:US
Mailing Address - Phone:913-297-7472
Mailing Address - Fax:816-382-3435
Practice Address - Street 1:8765 N AMBASSADOR DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-2540
Practice Address - Country:US
Practice Address - Phone:913-297-7472
Practice Address - Fax:816-382-3435
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014029345163W00000X
KS13-128748-072163W00000X
MO2018020916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse