Individual
ABA FAHNBULLEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1001 S GEORGE ST FL 2, YORK, PA 17403
(717) 851-2914
(717) 851-2479
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-2914
(717) 851-2479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP014415
PA
363LG0600X
Gerontology Nurse Practitioner
SPO14415
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003566432
HIGHMARK BS
PA
05
—
103274342
—
PA
01
—
6376004
UHC
PA
Enumeration date
05/15/2015
Last updated
12/05/2018
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