Provider Demographics
NPI:1922000215
Name:MCCLURE, JULIE (RN, MSN, CFNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:RN, MSN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 CALDER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1845
Mailing Address - Country:US
Mailing Address - Phone:409-833-9797
Mailing Address - Fax:409-654-6886
Practice Address - Street 1:2929 CALDER ST
Practice Address - Street 2:STE 100
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1841
Practice Address - Country:US
Practice Address - Phone:409-833-9797
Practice Address - Fax:409-654-6830
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX455401363L00000X
TXAP107095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039608701Medicaid
TXS56427Medicare UPIN
TX81N557Medicare PIN