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NPI Code Detail

MEDICARE: JORDANA FAITH POPOVICH CRNP

MEDICARE:   JORDANA FAITH POPOVICH  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 Practitioner024740PA

General Provider Information

NPI Number : 1700216983
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDANA FAITH POPOVICH CRNP
Provider Business Mailing Address
First Line : 100 OVERHILL RD
Second Line :
City : BALA CYNWYD
State : PA
Zip : 19004-2229
Country : US
Telephone Number : 610-649-2652
Fax Number :
Provider Business Practice Location Address
First Line : 701 MONTGOMERY AVE
Second Line : SUITE 18
City : PENN VALLEY
State : PA
Zip : 19072-2036
Country : US
Telephone Number : 610-642-9200
Fax Number : 610-649-4723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2013
Last Update Date : 03/22/2016

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Directions to “ JORDANA FAITH POPOVICH CRNP” Practice Location

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