Healthcare Provider Details

I. General information

NPI: 1679845200
Provider Name (Legal Business Name): MONICA J PERME CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 WEST LINCOLN HIGHWAY CHESTER COUNTY PEDIATRICS
EXTON PA
19341-2503
US

IV. Provider business mailing address

690 WEST LINCOLN HIGHWAY CHESTER COUNTY PEDIATRICS
EXTON PA
19341-2503
US

V. Phone/Fax

Practice location:
  • Phone: 610-873-5437
  • Fax: 484-879-6395
Mailing address:
  • Phone: 610-873-5437
  • Fax: 484-879-6395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP011825
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier1026830080001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: