MEDICARE: ALISON MARIE AHERN CRNP, IBCLC

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
1	163WL0100X	Lactation Consultant (Registered Nurse)	RN650949	PA
2	363LW0102X	Women's Health Nurse Practitioner	SP031946	PA

General Provider Information

NPI Number	:	1881196954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON MARIE AHERN CRNP, IBCLC

Provider Business Mailing Address
First Line	:	609 BREWSTER ALY
Second Line	:
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-2487
Country	:	US
Telephone Number	:	484-832-2515
Fax Number	:

Provider Business Practice Location Address
First Line	:	3704 MIDVALE AVE FL 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1715
Country	:	US
Telephone Number	:	484-832-2515
Fax Number	:	484-401-7914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	04/30/2025

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