Provider Demographics
NPI:1982005740
Name:MCCLURE, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
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 1:1355 OLD YORK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3413
Mailing Address - Country:US
Mailing Address - Phone:215-886-2433
Mailing Address - Fax:215-886-2432
Practice Address - Street 1:1355 OLD YORK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3413
Practice Address - Country:US
Practice Address - Phone:215-886-2433
Practice Address - Fax:215-886-2432
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAL-27013174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN