MEDICARE: JUDITH B GAWLIKOWSKI 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	363LF0000X	Family Nurse Practitioner	TP005346B	PA

General Provider Information

NPI Number	:	1790830412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH B GAWLIKOWSKI CRNP

Provider Business Mailing Address
First Line	:	455 WOODVIEW ROAD
Second Line	:	SUITE 100
City	:	WEST GROVE
State	:	PA
Zip	:	19390-9147
Country	:	US
Telephone Number	:	610-345-1900
Fax Number	:	610-345-1901

Provider Business Practice Location Address
First Line	:	455 WOODVIEW ROAD
Second Line	:	SUITE 100
City	:	WEST GROVE
State	:	PA
Zip	:	19390-9147
Country	:	US
Telephone Number	:	610-345-1900
Fax Number	:	610-345-1901

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	02/23/2026

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