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Organization
WOMEN TO WOMEN
Active
Organization
WOMEN TO WOMEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL FULLER CRNP (OWNER)
(570) 714-5880
Entity
Organization
Contact information
Practice address
400 3RD AVE, PARK OFFICE BUILDING 208 209, KINGSTON, PA 18704-5816
(570) 714-5800
(570) 714-0473
Mailing address
400 3RD AVE, PARK OFFICE BUILDING 208 209, KINGSTON, PA 18704-5816
(570) 714-5800
(570) 714-0473
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
TP000953B
PA
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100776761
—
PA
05
—
1007767610002
—
PA
05
—
1007767610004
—
PA
05
—
1007767610007
—
PA
05
—
1007767610008
—
PA
Enumeration date
04/23/2007
Last updated
12/17/2009
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