Individual
JUDITH VANNAERSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
311 E. BALTIMORE AVE, MEDIA, PA 19063
(484) 678-1875
Mailing address
1051 E. NIELS LANE, WEST CHESTER, PA 19382
(610) 696-7182
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC000784L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AETNA
INSURANCE
PA
Enumeration date
05/08/2007
Last updated
07/08/2007
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