Provider Demographics
NPI:1285156117
Name:MCCLURE, LINDSAY ANN ROSE (PA)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY ANN
Middle Name:ROSE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LINDSAY ANN
Other - Middle Name:ROSE
Other - Last Name:HOBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9201 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3332
Mailing Address - Country:US
Mailing Address - Phone:623-327-4000
Mailing Address - Fax:
Practice Address - Street 1:9201 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3332
Practice Address - Country:US
Practice Address - Phone:623-327-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6789363A00000X
AZ363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty