Healthcare Provider Details

I. General information

NPI: 1922580703
Provider Name (Legal Business Name): AMANDA HOPE ALCORN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PEARTREE WAY JAMESON HOSPITAL
BEAVER PA
15009-1954
US

IV. Provider business mailing address

740 E STATE ST
SHARON PA
16146-3328
US

V. Phone/Fax

Practice location:
  • Phone: 724-773-8960
  • Fax:
Mailing address:
  • Phone: 724-983-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019153
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: