Doctor Name: | CARLA JEAN VINCENT |
NPI Number: | 1023396850 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP004541B |
Business Practice Address: | 412 Gravel Pond Rd #3 South Abington Township, PA - 184118767 |
Business Phone Number: | 5705871355 |
Business Fax Number: | 5705871355 |
Mailing Address: | 412 Gravel Pond Rd, #3 SOUTH ABINGTON TOWNSHIP |
State: | PA |
Postal Code: | 184118767 |
Phone Number: | 5705871355 |
Fax Number: | 5705871355 |
NPI Enumeration Date: | 07/27/2011 |
NPI Last Update Date: | 07/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP004541B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |