Provider Demographics
NPI:1104549278
Name:MCCLURE, DENAE KAITLYN (PA-C)
Entity type:Individual
Prefix:
First Name:DENAE
Middle Name:KAITLYN
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:MT
Mailing Address - Zip Code:59471-0129
Mailing Address - Country:US
Mailing Address - Phone:406-366-5677
Mailing Address - Fax:
Practice Address - Street 1:2900 12TH AVE N STE 140W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7507
Practice Address - Country:US
Practice Address - Phone:406-238-6726
Practice Address - Fax:406-272-3395
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant