Healthcare Provider Details

I. General information

NPI: 1972056133
Provider Name (Legal Business Name): ANGELA LAFRANCE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE MOB EAST, SUITE 450
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

100 E LANCASTER AVE MOB EAST, SUITE 450
WYNNEWOOD PA
19096-3450
US

V. Phone/Fax

Practice location:
  • Phone: 610-896-0648
  • Fax: 610-642-1690
Mailing address:
  • Phone: 610-896-0648
  • Fax: 610-642-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP016343
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: