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NPI Code Detail

MEDICARE: ADVANCED FAMILY CLINIC

MEDICARE: ADVANCED FAMILY CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner

Other Identifiers

General Provider Information

NPI Number : 1225593346
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED FAMILY CLINIC
Provider Business Mailing Address
First Line : PO BOX 279
Second Line :
City : RICHMOND
State : KY
Zip : 40476-0279
Country : US
Telephone Number : 859-661-1930
Fax Number :
Provider Business Practice Location Address
First Line : 1619 FOXHAVEN DR # 1617
Second Line :
City : RICHMOND
State : KY
Zip : 40475-1056
Country : US
Telephone Number : 859-661-1930
Fax Number :
Authorized Official
Title or Position : OWNER
Name : HEATHER MCCLURE
Credential : APRN
Telephone Number : 859-353-9062
Provider Enumeration Date : 02/02/2019
Last Update Date : 02/02/2019

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Directions to “ADVANCED FAMILY CLINIC ” Practice Location

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