Doctor Name: | AMY JO PENCE |
NPI Number: | 1477824217 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP011879 |
Business Practice Address: | 307 S Lewis Rd Royersford, PA - 194681828 |
Business Phone Number: | 6107920300 |
Business Fax Number: | 6107923790 |
Mailing Address: | 1591 Medical Dr, POTTSTOWN |
State: | PA |
Postal Code: | 194643224 |
Phone Number: | 6103268005 |
Fax Number: | 6103279629 |
NPI Enumeration Date: | 01/25/2012 |
NPI Last Update Date: | 01/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP011879 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |