Individual
MICHELE MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
120 EXECUTIVE PARK, LOUISVILLE, KY 40207-4201
(502) 855-7200
(502) 855-7201
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3012101
KY
363LA2200X
Adult Health Nurse Practitioner
71007764A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001171736
ANTHEM PROVIDER ID NUMBER
—
01
—
14216057
CAQH PROVIDER ID
—
01
—
1594354
WELLCARE OF KY PROVIDER ID NUMBER
KY
05
—
300013667
—
IN
01
—
6570412
AETNA PROVIDER ID NUMBER
—
05
—
7100533270
—
KY
01
—
CS1823600597
CARESOURCE PROVIDER ID NUMBER
—
01
—
PDZ000000076638
AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
—
Enumeration date
11/15/2017
Last updated
06/09/2022
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