Provider Demographics
NPI:1780579227
Name:MCCLURE, LAURA JORDAN (MS, RN, CNM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JORDAN
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:MS, RN, CNM
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2238 WIDE REACH DR
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-8656
Mailing Address - Country:US
Mailing Address - Phone:770-990-3948
Mailing Address - Fax:
Practice Address - Street 1:6600 CHARING ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6110
Practice Address - Country:US
Practice Address - Phone:904-674-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife