Healthcare Provider Details

I. General information

NPI: 1124809652
Provider Name (Legal Business Name): COMMUNITY HOME CARE NURSE PRACTITIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 SELLERSVILLE DR
EAST STROUDSBURG PA
18302-8317
US

IV. Provider business mailing address

170 SELLERSVILLE DR
EAST STROUDSBURG PA
18302-8317
US

V. Phone/Fax

Practice location:
  • Phone: 570-672-4599
  • Fax:
Mailing address:
  • Phone: 570-672-4599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA CHRISTENSEN
Title or Position: CEO
Credential:
Phone: 973-945-3158