Healthcare Provider Details

I. General information

NPI: 1982908844
Provider Name (Legal Business Name): HWA SOON RIM ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 HARRISBURG PIKE SUITE 312
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

2112 HARRISBURG PIKE SUITE 312
LANCASTER PA
17601-2644
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3232
  • Fax: 717-544-3233
Mailing address:
  • Phone: 717-544-3232
  • Fax: 717-544-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704301795
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: