Healthcare Provider Details

I. General information

NPI: 1538140421
Provider Name (Legal Business Name): SUZANNE VOGT SHERRY CRNP MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 12/30/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 CHESTER PIKE
SHARON HILL PA
19079-1406
US

IV. Provider business mailing address

414 DREW AVE
SWARTHMORE PA
19081-2406
US

V. Phone/Fax

Practice location:
  • Phone: 484-496-7100
  • Fax: 610-271-9570
Mailing address:
  • Phone: 610-604-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberUP001471H
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: