Healthcare Provider Details

I. General information

NPI: 1053517946
Provider Name (Legal Business Name): MEKEESHA L MCCLURE PMHNP-BC, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEKEESHA L MCCLURE

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129-1237
US

IV. Provider business mailing address

3400 LEBANON PIKE
MURFREESBORO TN
37219
US

V. Phone/Fax

Practice location:
  • Phone: 615-225-3720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000156006
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN0000013769
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN13769
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: