Healthcare Provider Details

I. General information

NPI: 1568746204
Provider Name (Legal Business Name): SUSAN CHRISTINE HARRSCH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N. LANDSDOWNE AVE MATERNITY
DREXEL HILL PA
19026
US

IV. Provider business mailing address

577 S.HEILBRON DR
MEDIA PA
19063
US

V. Phone/Fax

Practice location:
  • Phone: 610-284-8598
  • Fax:
Mailing address:
  • Phone: 610-566-2878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberSP003399J
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: