Mersades McClam, LPN
Individual provider Active NPI Licensed Practical Nurse · Temple, PA
NPI 1043801376 · NPPES record last updated Jan 29, 2021
Key facts
- NPI
- 1043801376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN311098 (PA)
- Practice address
- 5101 Allentown Pike
Temple, PA 19560-1211 - Phone
- (610) 374-7000
- NPI assigned
- Jan 29, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN311098 | PA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN311098 | PA | Yes |
Addresses
Primary practice location
5101 Allentown Pike
Temple, PA 19560-1211
Mailing address
2111 Hampden Blvd Apt N11
Reading, PA 19604-1344
Phone (267) 644-6034
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- David Meyerson
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All providers in Temple, PA · Licensed Practical Nurse in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.