Healthcare Provider Details

I. General information

NPI: 1902630601
Provider Name (Legal Business Name): EDWARD JOSEPH MOYER JR. FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 EASTON RD STE 2500
WARRINGTON PA
18976-2907
US

IV. Provider business mailing address

847 EASTON RD STE 2500
WARRINGTON PA
18976-2907
US

V. Phone/Fax

Practice location:
  • Phone: 215-918-5555
  • Fax:
Mailing address:
  • Phone: 215-918-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP030513
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: