Healthcare Provider Details

I. General information

NPI: 1851231518
Provider Name (Legal Business Name): EMILY MARIE MCCLURE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S NATIONAL AVE
SPRINGFIELD MO
65897-0027
US

IV. Provider business mailing address

901 S NATIONAL AVE PROF 417
SPRINGFIELD MO
65897-0027
US

V. Phone/Fax

Practice location:
  • Phone: 417-836-8220
  • Fax:
Mailing address:
  • Phone: 417-836-8220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: