Organization
ADVANCED FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER MCCLURE APRN (OWNER)
(859) 353-9062
Entity
Organization
Contact information
Practice address
1619 FOXHAVEN DR # 1617, RICHMOND, KY 40475-1056
(859) 661-1930
Mailing address
PO BOX 279, RICHMOND, KY 40476-0279
(859) 661-1930
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100401390
—
KY
05
—
7100422330
—
KY
Enumeration date
02/02/2019
Last updated
02/02/2019
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