Provider Demographics
NPI:1942098843
Name:MCHARGUE, JENNY RAE (LPN)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:RAE
Last Name:MCHARGUE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-2890
Mailing Address - Country:US
Mailing Address - Phone:509-933-8245
Mailing Address - Fax:
Practice Address - Street 1:205 W 5TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-2887
Practice Address - Country:US
Practice Address - Phone:509-962-7619
Practice Address - Fax:509-962-7037
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00046245164W00000X
WALPOOO46245164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse