Provider Demographics
NPI:1518118587
Name:MCCLENDON, JENNIFER L (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:MCCLENDON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827 BOIX 2
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:ITALY
Mailing Address - Zip Code:FPO AE 09617
Mailing Address - Country:IT
Mailing Address - Phone:000-629-6475
Mailing Address - Fax:
Practice Address - Street 1:PSC 827
Practice Address - Street 2:BOX 2
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09617
Practice Address - Country:US
Practice Address - Phone:081-629-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677635163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine