Healthcare Provider Details

I. General information

NPI: 1770922528
Provider Name (Legal Business Name): ISHERWOOD'S WOMEN'S HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 06/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 SECURITY DR
YORK PA
17402-4727
US

IV. Provider business mailing address

1934 SECURITY DR
YORK PA
17402-4727
US

V. Phone/Fax

Practice location:
  • Phone: 717-793-3277
  • Fax:
Mailing address:
  • Phone: 717-793-3277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberUP005947V/RN326285L
License Number StatePA

VIII. Authorized Official

Name: MRS. JEAN THERESA ISHERWOOD
Title or Position: NURSE PRACTITIONER
Credential: CRNP
Phone: 717-793-3277