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General NPI Number Information
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NPI Number | 1558284638
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Entity Type | Individual
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Provider Name | JOHN EDWARD MC ENTEE III CRNP
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Gender | Male
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 5665 MAIN ST
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City | EAST PETERSBURG
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State | PA
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Zip | 17520-1551
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Country | US
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Telephone | 717-569-7011
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Fax |
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Provider Business Mailing Address
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Address Line | 2236 SHUMAKER RD
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City | MANHEIM
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State | PA
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Zip | 17545-9471
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Country | US
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Telephone | 717-682-4221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | RN652975
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License Number State | PA
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