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General NPI Number Information
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NPI Number | 1447413950
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Entity Type | Organization
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Legal Business Name | HOSPITAL UNIVERSITY OF PENNSYLVANIA
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 3400 SPRUCE ST 219 DULLES BUILDING
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 214-663-3064
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 SPRUCE ST 219 DULLES BUILDING
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 214-663-3064
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. RANDI L COLLINSON
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Credential | CRNP
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Telephone | 215-662-3572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | SP009033
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License Number State | PA
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