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General NPI Number Information
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NPI Number | 1982447231
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Entity Type | Organization
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Legal Business Name | MCCLUSKEY PRIMARY CARE LLC
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Dates
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Enumeration Date | 06/14/2024
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 215 INDUSTRIAL BLVD
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City | LEESBURG
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State | AL
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Zip | 35983-3742
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Country | US
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Telephone | 256-526-3331
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Fax | 256-526-3330
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Provider Business Mailing Address
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Address Line | 215 INDUSTRIAL BLVD STE C
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City | LEESBURG
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State | AL
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Zip | 35983-3742
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Country | US
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Telephone | 256-526-3331
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Fax | 256-526-3330
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Authorized Official
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Title or Position | OWNER/CRNP
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Name | KIMBERLY ANN MCCLUSKEY-JONES
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Credential | CRNP
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Telephone | 256-526-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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