Provider Demographics
NPI:1144089889
Name:MCCLURE, CRISTINA (CHC, IHP)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:CHC, IHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 HIGHWAY 180 E # 209
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7782
Mailing Address - Country:US
Mailing Address - Phone:575-313-4853
Mailing Address - Fax:
Practice Address - Street 1:5278 HWY 152
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NM
Practice Address - Zip Code:88041
Practice Address - Country:US
Practice Address - Phone:575-313-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach