Healthcare Provider Details

I. General information

NPI: 1104333566
Provider Name (Legal Business Name): ANNE M PRENDERGAST HITCHENS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

866 W BRISTOL RD
WARMINSTER PA
18974-2170
US

IV. Provider business mailing address

214 ALLISON RD
WILLOW GROVE PA
19090-3114
US

V. Phone/Fax

Practice location:
  • Phone: 215-293-6010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberSP016750
License Number StatePW

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: