Healthcare Provider Details

I. General information

NPI: 1871732578
Provider Name (Legal Business Name): ELIZABETH F HOBDELL CRNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FRONT STREET AT EERIE AVENUE
PHILADELPHIA PA
19134-1095
US

IV. Provider business mailing address

203 FAIRFAX CT
CHESTERBROOK PA
19087-5712
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5113
  • Fax: 215-427-4393
Mailing address:
  • Phone: 215-427-5113
  • Fax: 215-427-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberUP003353N
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: