Healthcare Provider Details

I. General information

NPI: 1851743991
Provider Name (Legal Business Name): MEGAN ELIZABETH ULMER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 E SWEDESFORD RD
WAYNE PA
19087-1606
US

IV. Provider business mailing address

222 LORNA DR
HATBORO PA
19040-1706
US

V. Phone/Fax

Practice location:
  • Phone: 813-289-9613
  • Fax: 484-253-1708
Mailing address:
  • Phone: 813-289-9613
  • Fax: 484-253-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015875
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: