Provider Demographics
NPI:1639416803
Name:MCCLURE-WILLIAMS, KRISTY K (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:K
Last Name:MCCLURE-WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:367 S GULPH RD
Mailing Address - Street 2:ATN :IPM CREDENTIALING
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:806-680-1900
Mailing Address - Fax:806-513-6791
Practice Address - Street 1:7200 SW 45TH AVE UNIT 14
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5084
Practice Address - Country:US
Practice Address - Phone:806-680-1900
Practice Address - Fax:806-513-6791
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX686400363L00000X, 363LP2300X
TXAP122983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care