Healthcare Provider Details

I. General information

NPI: 1912360967
Provider Name (Legal Business Name): COVENANT HOUSE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E BRINGHURST ST
PHILADELPHIA PA
19144-1719
US

IV. Provider business mailing address

251 E BRINGHURST ST
PHILADELPHIA PA
19144-1719
US

V. Phone/Fax

Practice location:
  • Phone: 215-844-1020
  • Fax: 215-844-2702
Mailing address:
  • Phone: 215-844-1020
  • Fax: 215-844-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number363LW0102X
License Number StatePA

VIII. Authorized Official

Name: MS. CHRISTIE N MORRIS
Title or Position: WHNP-OB-BC
Credential: MSN, BSN, RN
Phone: 267-918-3146