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General NPI Number Information
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NPI Number | 1619528833
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Entity Type | Individual
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Provider Name | ELIZABETH PAK CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2019
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 390 COMMERCE DR # 220
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-2600
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Country | US
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Telephone | 267-715-2089
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Fax | 267-361-1300
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Provider Business Mailing Address
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Address Line | 390 COMMERCE DR # 220
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-2600
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Country | US
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Telephone | 267-715-2089
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Fax | 267-361-1300
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP020867
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License Number State | PA
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