Provider Demographics
NPI:1033392980
Name:VEITZ, ALICE L (MSN CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:L
Last Name:VEITZ
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1645
Mailing Address - Country:US
Mailing Address - Phone:610-725-0650
Mailing Address - Fax:610-725-9583
Practice Address - Street 1:2 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1645
Practice Address - Country:US
Practice Address - Phone:610-725-0650
Practice Address - Fax:610-725-9583
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAVP005462X364SX0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS64044Medicare UPIN