Individual
ALEXIS IRENE MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
750 N BROADWAY, PERU, IN 46970-1027
(260) 569-2120
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
99999999999
IN
363A00000X
Physician Assistant
Primary
10005026A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/09/2024
Last updated
10/30/2025
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