Individual
MICHAEL D HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-8887
(717) 531-4475
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP016471
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031946260001
—
PA
Enumeration date
07/01/2016
Last updated
12/09/2019
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