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NPI Code Detail

MEDICARE: VIVIAN E HENRY CRNP

MEDICARE: VIVIAN E HENRY CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerSP017648PA

General Provider Information

NPI Number : 1265967616
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN E HENRY CRNP
Provider Business Mailing Address
First Line : 601 MEMORY LN
Second Line :
City : YORK
State : PA
Zip : 17402-2231
Country : US
Telephone Number : 717-851-1405
Fax Number : 717-851-6969
Provider Business Practice Location Address
First Line : 775 NORMAN DR
Second Line :
City : LEBANON
State : PA
Zip : 17042-7497
Country : US
Telephone Number : 717-272-8173
Fax Number : 717-272-4029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2017
Last Update Date : 05/06/2026

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Directions to “ VIVIAN E HENRY CRNP” Practice Location

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