Provider Demographics
NPI:1568167732
Name:CORNITCHER, RHONDA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:CORNITCHER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-4439
Mailing Address - Country:US
Mailing Address - Phone:215-284-6487
Mailing Address - Fax:
Practice Address - Street 1:1200 BUSTLETON PIKE STE 7
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4108
Practice Address - Country:US
Practice Address - Phone:267-288-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA027383363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health