Healthcare Provider Details

I. General information

NPI: 1386367399
Provider Name (Legal Business Name): ASHLEY GINCEL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEDICAL CENTER BLVD STE 202
CHESTER PA
19013-3956
US

IV. Provider business mailing address

30 MEDICAL CENTER BLVD STE 202
CHESTER PA
19013-3956
US

V. Phone/Fax

Practice location:
  • Phone: 610-447-8840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP026286
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPPA052534
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: