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General NPI Number Information
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NPI Number | 1902178544
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Entity Type | Individual
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Provider Name | CHRISTOPHER J MCMENEMY M.S.N., C.R.N.P
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Gender | Male
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Dates
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Enumeration Date | 01/28/2012
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Last Update Date | 01/28/2012
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Provider Practice Location Address
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Address Line | 111 S 11TH ST CASE MGMT. OFFICE 8TH FL. GIBBON BLDG.
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 215-955-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 111 S 11TH ST CASE MGMT. OFFICE 8TH FL. GIBBON BLDG.
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP011204
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License Number State | PA
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