Provider Demographics
NPI:1497878318
Name:MCCLURE, JOSEPHINE LOUISE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:LOUISE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 724
Mailing Address - Street 2:10142 SINGER LN
Mailing Address - City:RYE
Mailing Address - State:CO
Mailing Address - Zip Code:81069-0724
Mailing Address - Country:US
Mailing Address - Phone:719-489-2853
Mailing Address - Fax:719-489-2835
Practice Address - Street 1:314 W 16TH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2728
Practice Address - Country:US
Practice Address - Phone:719-546-3511
Practice Address - Fax:719-583-1292
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO70966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily