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NPI Code Detail

MEDICARE: NICOLE MARIE GHEEN GNP-BC

MEDICARE: NICOLE MARIE GHEEN GNP-BC
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 PractitionerSP009752PA
2363LG0600XGerontology Nurse PractitionerSP009752PA

General Provider Information

NPI Number : 1962678300
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MARIE GHEEN GNP-BC
Provider Business Mailing Address
First Line : 1245 CHURCH RD
Second Line :
City : WYNCOTE
State : PA
Zip : 19095-1800
Country : US
Telephone Number : 215-884-9990
Fax Number :
Provider Business Practice Location Address
First Line : 1245 CHURCH RD
Second Line :
City : WYNCOTE
State : PA
Zip : 19095-1800
Country : US
Telephone Number : 215-884-9990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2008
Last Update Date : 05/06/2008

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