Provider Demographics
NPI:1831466093
Name:MCCLURE, RACHAEL ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:RACHAEL
Other - Middle Name:ELIZABETH
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 E OLNEY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-456-1825
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:559 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4250
Practice Address - Country:US
Practice Address - Phone:484-622-1248
Practice Address - Fax:484-622-1269
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15674800163W00000X
NJ26NJ00358900367500000X
PARN569280367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse