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NPI Code Detail

MEDICARE: MANDY PLANK

MEDICARE:   MANDY  PLANK
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
1164W00000XLicensed Practical NursePN275610PA

General Provider Information

NPI Number : 1568605541
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDY PLANK
Provider Business Mailing Address
First Line : 576 E BERLIN RD
Second Line :
City : YORK SPRINGS
State : PA
Zip : 17372-8746
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2250 HICKORY RD
Second Line :
City : PLYMOUTH MEETING
State : PA
Zip : 19462-1047
Country : US
Telephone Number : 610-834-1122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2009
Last Update Date : 04/07/2009

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