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Individual

SUSAN FENDRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
34TH STREET AND CIVIC CENTER BLVD., CHILDRENS HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104
(215) 590-1000
Mailing address
15 BRAMLEY RD, MOORESTOWN, NJ 08057-3861

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN26NR05571500
NJ
163W00000X
Registered Nurse
Primary
RN356630L
PA
363LP0200X
Pediatric Nurse Practitioner
SP007820
PA

Other

Enumeration date
06/13/2006
Last updated
09/12/2007
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