Healthcare Provider Details

I. General information

NPI: 1144463688
Provider Name (Legal Business Name): KRISTEN YOO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E LANCASTER AVE
BRYN MAWR PA
19010-1451
US

IV. Provider business mailing address

1030 E LANCASTER AVE
BRYN MAWR PA
19010-1451
US

V. Phone/Fax

Practice location:
  • Phone: 610-525-3225
  • Fax: 610-525-4932
Mailing address:
  • Phone: 610-525-3225
  • Fax: 610-525-4932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP009575
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: