Provider Demographics
NPI:1093184392
Name:HEDIAN, WANDA (MSN,APRN,FNP-C,PMHNP)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:HEDIAN
Suffix:
Gender:F
Credentials:MSN,APRN,FNP-C,PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODMONT DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-8611
Mailing Address - Country:US
Mailing Address - Phone:551-206-7665
Mailing Address - Fax:
Practice Address - Street 1:822 MONTGOMERY AVE STE 314
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1948
Practice Address - Country:US
Practice Address - Phone:610-455-4254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00580800363LF0000X
PASP023302363LF0000X
PASP028297363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily