Healthcare Provider Details

I. General information

NPI: 1326269473
Provider Name (Legal Business Name): REBECCA S MCCLURE RN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 VAN REED RD STE 101
WYOMISSING PA
19610-1799
US

IV. Provider business mailing address

560 VAN REED RD STE 101
WEST READING PA
19610-1799
US

V. Phone/Fax

Practice location:
  • Phone: 484-516-2937
  • Fax: 484-930-0229
Mailing address:
  • Phone: 484-516-2937
  • Fax: 484-930-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN254674L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberUP004938G
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberUP004938G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: