Provider Demographics
NPI:1417938531
Name:BOSNICK, EVE (MSN,CRNP)
Entity Type:Individual
Prefix:MRS
First Name:EVE
Middle Name:
Last Name:BOSNICK
Suffix:
Gender:F
Credentials:MSN,CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 STRADONE RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2113
Mailing Address - Country:US
Mailing Address - Phone:610-668-2608
Mailing Address - Fax:
Practice Address - Street 1:701 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072-2036
Practice Address - Country:US
Practice Address - Phone:610-642-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021660363LP0808X
PAUP001994-D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health