Provider Demographics
NPI:1932354131
Name:MCGLADE, AMANDA LYNNE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYNNE
Last Name:MCGLADE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:LYNNE
Other - Last Name:LUNDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:727 WELSH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6310
Mailing Address - Country:US
Mailing Address - Phone:215-914-0600
Mailing Address - Fax:215-914-0115
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6310
Practice Address - Country:US
Practice Address - Phone:215-914-0600
Practice Address - Fax:215-914-0115
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF1008194363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner