Provider Demographics
NPI:1992275457
Name:MCCLURE, TAMMY LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:FNP-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:490 WINDMILL HILL RD
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-8591
Mailing Address - Country:US
Mailing Address - Phone:864-237-2554
Mailing Address - Fax:803-641-3939
Practice Address - Street 1:10 PARKWAY S
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5096
Practice Address - Country:US
Practice Address - Phone:864-458-6933
Practice Address - Fax:866-950-0121
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC22450363LF0000X
261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology