MEDICARE: MISS DARLENE MARIE BEWICK 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
1	363LA2200X	Adult Health Nurse Practitioner	SP-007741	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548291594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DARLENE MARIE BEWICK CRNP

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST
Second Line	:	SUITE 703
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4414
Country	:	US
Telephone Number	:	215-955-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	833 CHESTNUT ST STE 703
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4409
Country	:	US
Telephone Number	:	215-955-1000
Fax Number	:	215-503-2066

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	12/04/2015

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