Healthcare Provider Details

I. General information

NPI: 1003207598
Provider Name (Legal Business Name): STEPHANIE ANN HARRIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 NEWTOWN RD
WARMINSTER PA
18974-5221
US

IV. Provider business mailing address

2500 MARYLAND RD STE 400
WILLOW GROVE PA
19090-1225
US

V. Phone/Fax

Practice location:
  • Phone: 215-441-6650
  • Fax: 215-540-4415
Mailing address:
  • Phone: 215-481-4143
  • Fax: 215-481-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP014538
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: