Active NPI
Maureen P Glendon, MSN, ARNP,BC, CRNP
- Pediatric Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1548301765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN193224-L
- Practice address
- 11201 Academy Rd
Philadelphia, PA 19154-3303 - Phone
- (215) 637-1800
- Fax
- (215) 637-8833
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN193224-L | PA | Primary |
Addresses
Primary practice location
11201 Academy Rd
Philadelphia, PA 19154-3303
Mailing address
984 Wesley Ave
Huntingdon Valley, PA 19006-8622
Phone (215) 379-1116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN193224-L | PA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548301765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "984 WESLEY AVE",
"city": "HUNTINGDON VALLEY",
"state": "PA",
"postal_code": "190068622",
"telephone_number": "215-379-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 ACADEMY RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191543303",
"telephone_number": "215-637-1800",
"fax_number": "215-637-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENDON",
"first_name": "MAUREEN",
"middle_name": "P",
"name_prefix": "Ms.",
"credential": "MSN, ARNP,BC, CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "RN193224-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.