Provider Demographics
NPI:1427869635
Name:CLENDANIEL, DARLENE (APN,PMHNP)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:CLENDANIEL
Suffix:
Gender:F
Credentials:APN,PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1902
Mailing Address - Country:US
Mailing Address - Phone:856-340-9830
Mailing Address - Fax:
Practice Address - Street 1:14 N PEARL ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1902
Practice Address - Country:US
Practice Address - Phone:856-340-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15256600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health