Provider Demographics
NPI:1184392649
Name:MCCLURE, SHELLEY JANE (DNP, APRN-CNP, FNP-C)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:JANE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:DNP, APRN-CNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 36TH AVE NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3280
Mailing Address - Country:US
Mailing Address - Phone:405-407-2167
Mailing Address - Fax:405-107-2168
Practice Address - Street 1:2260 36TH AVE NW STE 110
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3280
Practice Address - Country:US
Practice Address - Phone:405-407-2167
Practice Address - Fax:405-407-2168
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK200276363LF0000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
.Other.