Provider Demographics
NPI:1366200313
Name:MCKENDRY, EMILY R (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:MCKENDRY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 EDGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-3837
Mailing Address - Country:US
Mailing Address - Phone:267-266-2278
Mailing Address - Fax:
Practice Address - Street 1:672 EDGE HILL RD
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-3837
Practice Address - Country:US
Practice Address - Phone:126-726-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN639425163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics