Healthcare Provider Details

I. General information

NPI: 1679857791
Provider Name (Legal Business Name): LOUISE A FROMUTH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2011
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 HARRISBURG PIKE STE 22
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

333 N ARCH ST
LANCASTER PA
17603-2928
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-0375
  • Fax: 717-544-0376
Mailing address:
  • Phone: 717-299-6371
  • Fax: 717-945-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP011350
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: