Provider Demographics
NPI:1639938129
Name:MCCLURE, EMILY MARIE
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MARIE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 COUNTY ROUTE 17
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:NY
Mailing Address - Zip Code:13684-3151
Mailing Address - Country:US
Mailing Address - Phone:315-854-2803
Mailing Address - Fax:
Practice Address - Street 1:315 COUNTY ROUTE 17
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:NY
Practice Address - Zip Code:13684-3151
Practice Address - Country:US
Practice Address - Phone:315-854-2803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula