Healthcare Provider Details

I. General information

NPI: 1003976895
Provider Name (Legal Business Name): JAMIE L DILLINGER C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 INDUSTRIAL BLVD SUITE 101
PAOLI PA
19301-1610
US

IV. Provider business mailing address

21 INDUSTRIAL BLVD SUITE 101
PAOLI PA
19301-1610
US

V. Phone/Fax

Practice location:
  • Phone: 610-251-0300
  • Fax: 610-251-0304
Mailing address:
  • Phone: 610-251-0300
  • Fax: 610-251-0304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008955
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: