Clancy, Christine Nieroda

Clancy, Christine Nieroda is an individual health care provider with primary practice located at 211 S. 9Th Street Suite 600, Philadelphia PA 19107. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Clancy, Christine Nieroda can be contacted via phone (215) 955-1925.

Contact Information

Primary practice address
211 S. 9Th Street Suite 600 Philadelphia PA 19107
Phone: (215) 955-1925
Fax: (215) 928-3160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X VP004645C Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X VP004645C Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X VP004645C Pennsylvania

Profile Details

NPI number 1487677084
LBN Legal business name Clancy, Christine Nieroda
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Oct 25th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487677084 NPPES
Pennsylvania MEDICAID 103075213

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