Provider Demographics
NPI:1447413950
Name:HOSPITAL UNIVERSITY OF PENNSYLVANIA
Entity Type:Organization
Organization Name:HOSPITAL UNIVERSITY OF PENNSYLVANIA
Other - Org Name:UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:215-662-3572
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:219 DULLES BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:214-663-3064
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:219 DULLES BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:214-663-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009033282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural