Healthcare Provider Details

I. General information

NPI: 1588286041
Provider Name (Legal Business Name): EMILY BROOKE SAPEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 HOPE DR STE 3101
HERSHEY PA
17033-2036
US

IV. Provider business mailing address

90 HOPE DR STE 3101
HERSHEY PA
17033-2036
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-0003
  • Fax:
Mailing address:
  • Phone: 717-531-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN708794
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: