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NPI Code Detail

MEDICARE: MARCIAROSE WINSTON CRNP

MEDICARE:   MARCIAROSE  WINSTON  CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerSP001875DPA

General Provider Information

NPI Number : 1225027808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIAROSE WINSTON CRNP
Provider Business Mailing Address
First Line : 210 LOCUST ST
Second Line : UNIT 8C
City : PHILADELPHIA
State : PA
Zip : 19106-3934
Country : US
Telephone Number : 215-627-5552
Fax Number :
Provider Business Practice Location Address
First Line : 34TH STREET & CIVIC CENTER BOULEVARD
Second Line : THE CHILDREN'S HOSPITAL OF PHILADELPHIA
City : PHILADELPHIA
State : PA
Zip : 19104-4399
Country : US
Telephone Number : 215-590-3749
Fax Number : 215-590-3500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 07/08/2007

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