Healthcare Provider Details

I. General information

NPI: 1487611976
Provider Name (Legal Business Name): PAUL RICHARD O'LAUGHLIN MSN, APRN, BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W 9TH ST CROZER COMMUNITY HOSPITAL
CHESTER PA
19013
US

IV. Provider business mailing address

131 PLYMOUTH RD
SPRINGFIELD PA
19064-1308
US

V. Phone/Fax

Practice location:
  • Phone: 610-497-7693
  • Fax: 610-497-7711
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN207888L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: