Healthcare Provider Details

I. General information

NPI: 1942281837
Provider Name (Legal Business Name): NOMI HORN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E STREET RD
KENNETT SQUARE PA
19348-2028
US

IV. Provider business mailing address

660 GLENWYD RD
BRYN MAWR PA
19010-2018
US

V. Phone/Fax

Practice location:
  • Phone: 610-388-5600
  • Fax: 610-388-5691
Mailing address:
  • Phone: 610-527-2207
  • Fax: 610-527-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberTP003097H
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: