Provider Demographics
NPI:1174243596
Name:MCCLURE, WHITNEY CAROLYN (RN)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:CAROLYN
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4535 PECKINPAUGH DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-2617
Mailing Address - Country:US
Mailing Address - Phone:904-566-2500
Mailing Address - Fax:
Practice Address - Street 1:921 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2102
Practice Address - Country:US
Practice Address - Phone:423-209-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000236015163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health