Healthcare Provider Details

I. General information

NPI: 1548421381
Provider Name (Legal Business Name): ANDREA KIRSCH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE SUITE 433 WEST, LANKENAU HOSPITAL
WYNNEWOOD PA
19096-3450
US

IV. Provider business mailing address

PO BOX 22581
NEW YORK NY
10087-2581
US

V. Phone/Fax

Practice location:
  • Phone: 610-896-8840
  • Fax: 610-642-5148
Mailing address:
  • Phone: 610-482-4795
  • Fax: 856-528-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP003254G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: