Healthcare Provider Details

I. General information

NPI: 1902492820
Provider Name (Legal Business Name): CAROL LYNN GRIEB CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E MARSHALL ST STE 205
WEST CHESTER PA
19380-4453
US

IV. Provider business mailing address

600 E MARSHALL ST STE 205
WEST CHESTER PA
19380-4453
US

V. Phone/Fax

Practice location:
  • Phone: 610-903-6200
  • Fax: 610-903-6201
Mailing address:
  • Phone: 610-903-6200
  • Fax: 610-903-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP022493
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: