Organization
MERCY MANAGEMENT OF SEPA
Active
Other names
SEPA Midlevel Practioners
Organization subpart
No
Provider details
NPI number
Authorized official
AMIEE BRENNAN (CREDENTIALING SUPERVISOR)
(610) 567-6964
Entity
Organization
Contact information
Practice address
1503 LANSDOWNE AVE STE 3003, DARBY, PA 19023-1308
(484) 494-6862
(484) 494-8414
Mailing address
1 W ELM ST, CONSHOHOCKEN, PA 19428-4108
(610) 567-6967
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/17/2017
Last updated
03/17/2018
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