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Individual

MARY E MCCLENDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4717 CAVALIER DR, LOUISVILLE, KY 40216-2933
(502) 448-9475
Mailing address
4717 CAVALIER DR., LOUISVILLE, KY 40216

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R31483
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016H5MC
MNBS #
ND
05
13647
ND
01
2003086
MEDICA #
ND
01
2394104
AMERICA'S PPO/ARAZ #
ND
05
26200
ND
01
47900
LHS #
ND
01
DA9011046497
PREFERRED ONE #
ND
01
HP57109
HELATHPARTNERS #
ND
Enumeration date
05/18/2006
Last updated
07/09/2007
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