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General NPI Number Information
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NPI Number | 1255058012
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Entity Type | Individual
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Provider Name | NICOLE SAMANTHA TOURLITIS CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 609 W GERMANTOWN PIKE STE 210
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City | EAST NORRITON
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State | PA
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Zip | 19403-4251
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Country | US
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Telephone | 610-649-1175
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Fax | 610-279-4841
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Provider Business Mailing Address
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Address Line | 609 W GERMANTOWN PIKE STE 210
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City | EAST NORRITON
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State | PA
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Zip | 19403-4251
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Country | US
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Telephone | 610-649-1175
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Fax | 610-279-4841
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP027033
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License Number State | PA
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