Doctor Name: | MRS. PAULINE S COUSINEAU |
NPI Number: | 1538426424 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SP012053 |
Business Practice Address: | 1011 W Baltimore Pike Suite 304 West Grove, PA - 193909446 |
Business Phone Number: | 6108691278 |
Business Fax Number: | |
Mailing Address: | 111 Cromwell Dr, LINCOLN UNIVERSITY |
State: | PA |
Postal Code: | 193521120 |
Phone Number: | 6109999441 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2012 |
NPI Last Update Date: | 04/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | SP012053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |