Healthcare Provider Details
I. General information
NPI: 1871040295
Provider Name (Legal Business Name): CHARLOTTE M SAUNDERS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/01/2016
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
510 E BALTIMORE PIKE
MEDIA PA
19063-3836
US
IV. Provider business mailing address
501 S 54TH ST STE 26
PHILADELPHIA PA
19143-1900
US
V. Phone/Fax
- Phone: 610-566-3218
- Fax:
- Phone: 215-748-9200
- Fax: 215-748-9307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | L1-0046178 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | LG-0012543 |
| License Number State | DE |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP016528 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: