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General NPI Number Information
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NPI Number | 1942693254
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Entity Type | Organization
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Legal Business Name | THE RIVER PRACTICE
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 3135 NEW GERMANY RD STE 24
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City | EBENSBURG
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State | PA
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Zip | 15931-4347
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Country | US
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Telephone | 814-418-7759
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Fax |
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Provider Business Mailing Address
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Address Line | 220 PINE ST
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City | DAVIDSVILLE
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State | PA
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Zip | 15928-8315
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Country | US
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Telephone | 814-270-0733
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. CHARLENE MCFEELEY
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Credential | NURSE PRACTITIONER
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Telephone | 814-270-0733
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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 | SP005712B
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License Number State | PA
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