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General NPI Number Information
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NPI Number | 1184738338
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Entity Type | Individual
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Provider Name | DEREK ROBERT MCCLURE FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 952 US HIGHWAY 221 BUS
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City | WEST JEFFERSON
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State | NC
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Zip | 28694
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Country | US
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Telephone | 336-846-6100
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Fax | 336-846-7900
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | WEST JEFFERSON
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State | NC
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Zip | 28694-0070
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Country | US
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Telephone | 336-846-6100
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Fax | 336-846-7900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201844
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 201844
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License Number State | NC
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