Healthcare Provider Details

I. General information

NPI: 1861374696
Provider Name (Legal Business Name): EMILY JANE MCCLURE DAVIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY MCCLURE

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 HARRISON AVENUE, 3RD FL MOAKLEY BLDG
BOSTON MA
02118-2905
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE FL 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-6428
  • Fax: 617-638-5756
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN2341754
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: