Healthcare Provider Details

I. General information

NPI: 1295868594
Provider Name (Legal Business Name): CHRISTINE H HUTNYK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE H HEUCHERT CRNP

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NORTH WEST END BOULEVARD SUITE 104
QUAKERTOWN PA
18951-1272
US

IV. Provider business mailing address

PO BOX 1111
HARLEYSVILLE PA
19438-0907
US

V. Phone/Fax

Practice location:
  • Phone: 215-536-3200
  • Fax: 215-536-3259
Mailing address:
  • Phone: 215-453-4995
  • Fax: 215-453-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberVP004590G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: