Provider Demographics
NPI:1053517946
Name:MCCLURE, MEKEESHA L (PMHNP-BC, ANP-BC)
Entity type:Individual
Prefix:
First Name:MEKEESHA
Middle Name:L
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:PMHNP-BC, ANP-BC
Other - Prefix:
Other - First Name:MEKEESHA
Other - Middle Name:L
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1237
Practice Address - Country:US
Practice Address - Phone:615-225-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000156006163W00000X
TNAPN0000013769363LA2200X
TNAPN13769363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I505004Medicare PIN
TN103I505002Medicare PIN
TN103I505001Medicare PIN
TN103I505003Medicare PIN