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General NPI Number Information
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NPI Number | 1689530180
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Entity Type | Organization
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Legal Business Name | BEACON OF HEALTH
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1420 HUNTINGDON PIKE
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006
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Country | US
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Telephone | 267-571-6363
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Fax |
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Provider Business Mailing Address
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Address Line | 1657 THE FAIRWAY STE 1161
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City | JENKINTOWN
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State | PA
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Zip | 19046-1423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CRNP
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Name | MS. KHADIAN SMITH
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Credential | NP
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Telephone | 215-571-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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