Healthcare Provider Details
I. General information
NPI: 1891031076
Provider Name (Legal Business Name): RENATA ESTES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/17/2012
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 WELSH RD BLDG 2
HORSHAM PA
19044-2248
US
IV. Provider business mailing address
1101 MARKET ST FL 19
PHILADELPHIA PA
19107-2926
US
V. Phone/Fax
- Phone: 215-481-4212
- Fax:
- Phone: 215-481-6836
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | SP012393 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 26NJ00406100 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: