Healthcare Provider Details

I. General information

NPI: 1972322436
Provider Name (Legal Business Name): THERESA SAXON RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 PULASKI DR STE 100
KING OF PRUSSIA PA
19406-2802
US

IV. Provider business mailing address

PO BOX 34990
BELFAST ME
04915-0627
US

V. Phone/Fax

Practice location:
  • Phone: 610-768-5940
  • Fax:
Mailing address:
  • Phone: 610-359-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN315284L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: