Provider Demographics
NPI:1952672941
Name:MCCLURE, RYAN PATRICK (RN)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 HUNT RD APT 11
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3952
Mailing Address - Country:US
Mailing Address - Phone:513-258-9721
Mailing Address - Fax:
Practice Address - Street 1:1715 HUNT RD APT 11
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-3952
Practice Address - Country:US
Practice Address - Phone:513-258-9721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343924163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse