Individual
PHYLLIS MCLEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1901 MEDI PARK, STE 2051, AMARILLO, TX 79106-2169
(806) 468-4600
(806) 468-4398
Mailing address
1400 WALLACE BLVD, ATTN: CREDENTIALING DEPT, AMARILLO, TX 79106-1708
(806) 354-5585
(806) 356-4673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
517550
TX
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
517550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042483005
—
TX
05
—
042483006
—
TX
05
—
05572568
—
NM
05
—
200322680 A
—
OK
Enumeration date
07/21/2008
Last updated
03/09/2012
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