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Organization
MARILYN J. MCCLURE
Active
Organization
MARILYN J. MCCLURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN JEANNE MCCLURE MSN-FNP (FAMILY NURSE PRACTITIONER)
(707) 986-7176
Entity
Organization
Contact information
Practice address
3536 MENDOCINO AVE, SUITE 360, SANTA ROSA, CA 95403-3634
(707) 577-7800
Mailing address
448 SEAFOAM RD, SHELTER COVE, CA 95589-9107
(707) 986-7176
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
C148295
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP0131510
BLUE SHIELD INSURANCE CO
—
Enumeration date
03/29/2006
Last updated
08/22/2020
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