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NPI Code Detail

MEDICARE: NANETTE MCCLURE FNP-C

MEDICARE: NANETTE MCCLURE FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner18228TN

General Provider Information

NPI Number : 1669884425
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANETTE MCCLURE FNP-C
Provider Business Mailing Address
First Line : 9069 FULTON LN
Second Line :
City : CORDOVA
State : TN
Zip : 38016-5376
Country : US
Telephone Number : 901-372-8062
Fax Number :
Provider Business Practice Location Address
First Line : 4100 AUSTIN PEAY HWY
Second Line :
City : MEMPHIS
State : TN
Zip : 38128-2502
Country : US
Telephone Number : 901-213-5460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2014
Last Update Date : 07/11/2014

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Directions to “ NANETTE MCCLURE FNP-C” Practice Location

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