Healthcare Provider Details

I. General information

NPI: 1255416566
Provider Name (Legal Business Name): SUSAN KUTCHINSKY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E MARSHALL ST SUITE 101
WEST CHESTER PA
19380-5414
US

IV. Provider business mailing address

23 MOONEY LN
CHESTER SPRINGS PA
19425-2213
US

V. Phone/Fax

Practice location:
  • Phone: 610-738-7710
  • Fax: 610-738-7714
Mailing address:
  • Phone: 610-524-4268
  • Fax: 610-738-7714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License NumberUP005951T
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: