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General NPI Number Information
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NPI Number | 1043893761
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Entity Type | Individual
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Provider Name | GANINE MARIE HAMBLEY CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 3400 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4238
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Country | US
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Telephone | 215-662-3487
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Fax |
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Provider Business Mailing Address
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Address Line | 434 SUMMIT AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-4350
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Country | US
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Telephone | 910-728-9255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP023664
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License Number State | PA
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