Individual
CARLENE M MCCLURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
301 E MAUMEE ST, ANGOLA, IN 46703-2012
(260) 667-5635
(260) 665-8852
Mailing address
416 E MAUMEE ST, ANGOLA, IN 46703-2015
(260) 667-5131
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000700A
IN
363LF0000X
Family Nurse Practitioner
71000700A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490402
ANTHEM BLUE CROSS
IN
Enumeration date
07/12/2006
Last updated
03/07/2024
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