Provider Demographics
NPI:1962482364
Name:HARRICK, JAMESINA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:JAMESINA
Middle Name:MARIE
Last Name:HARRICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 COUNTY LINE ROAD
Mailing Address - Street 2:THE BIRTH CENTER
Mailing Address - City:BYRN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-525-6086
Mailing Address - Fax:610-525-1846
Practice Address - Street 1:918 COUNTY LINE ROAD
Practice Address - Street 2:THE BIRTH CENTER
Practice Address - City:BYRN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-525-6086
Practice Address - Fax:610-525-1846
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJME00041200367A00000X
PAMW010082367A00000X
PASP008470363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0113042Medicaid
NJ0113042Medicaid