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Individual

DORIS WENGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
495 HIGHLANDS BLVD, SUITE 100, COATESVILLE, PA 19320
(610) 384-9500
(610) 384-3998
Mailing address
495 HIGHLANDS BLVD, SUITE 100, COATESVILLE, PA 19320
(610) 384-9500
(610) 384-3998

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
VP001911D
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005397
PRESCRIPTION AUTH
PA
01
RN193094L
RN LICENSE
PA
01
VP001911D
CRNP LICENSE
PA
Enumeration date
05/11/2007
Last updated
07/08/2007
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