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General NPI Number Information
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NPI Number | 1225771371
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Entity Type | Organization
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Legal Business Name | BRANCH BEHAVIORAL HEALTH SERVICE VIRTUAL PSYCHIATRY
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Dates
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Enumeration Date | 04/17/2022
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 840 FIRST AVE STE 400
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4062
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Country | US
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Telephone | 610-934-2200
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Fax | 610-885-0801
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Provider Business Mailing Address
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Address Line | 1150 FIRST AVE STE 501
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1316
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Country | US
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Telephone | 610-934-2200
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROXANNE JEFFRIES-BAXTER
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Credential | CRNP
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Telephone | 267-307-2077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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