Provider Demographics
NPI:1184630295
Name:EHRHORN, GEORGE C (CRNP)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:C
Last Name:EHRHORN
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-0032
Mailing Address - Country:US
Mailing Address - Phone:215-257-6551
Mailing Address - Fax:215-257-9347
Practice Address - Street 1:807 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1549
Practice Address - Country:US
Practice Address - Phone:215-257-6551
Practice Address - Fax:215-453-5181
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006939L163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA35039000OtherMAGELLAN BEHAVIORAL HEALT
PAP58506OtherUPIN
PA35039000OtherMAGELLAN BEHAVIORAL HEALT