Provider Demographics
NPI:1922027093
Name:NORTH PENN VISITNG NURSE ASSOCIATION
Entity Type:Organization
Organization Name:NORTH PENN VISITNG NURSE ASSOCIATION
Other - Org Name:NORTH PENN VNA CHILDREN'S CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FITAGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:215-855-8296
Mailing Address - Street 1:51 MEDICAL CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1254
Mailing Address - Country:US
Mailing Address - Phone:215-855-8296
Mailing Address - Fax:215-855-1305
Practice Address - Street 1:51 MEDICAL CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1254
Practice Address - Country:US
Practice Address - Phone:215-855-8296
Practice Address - Fax:215-855-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000070220009Medicaid
PA1595129OtherPERSONAL CHOICE
PA1129109OtherKEYSTONE