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General NPI Number Information
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NPI Number | 1013135284
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Entity Type | Organization
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Legal Business Name | WOMEN TO WOMEN
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 12/17/2009
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Provider Practice Location Address
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Address Line | 400 3RD AVE PARK OFFICE BUILDING 208 209
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City | KINGSTON
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State | PA
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Zip | 18704-5816
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Country | US
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Telephone | 570-714-5800
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Fax | 570-714-0473
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Provider Business Mailing Address
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Address Line | 400 3RD AVE PARK OFFICE BUILDING 208 209
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City | KINGSTON
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State | PA
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Zip | 18704-5816
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Country | US
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Telephone | 570-714-5800
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Fax | 570-714-0473
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHERYL FULLER
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Credential | CRNP
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Telephone | 570-714-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | TP000953B
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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