Basic Information
| Provider Information | |||||||||
| NPI: | 1093812117 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ECKART | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | CAROL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 EVERGREEN DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105793555 | ||||||||
| FaxNumber: | 6105793566 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 EVERGREEN DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105793555 | ||||||||
| FaxNumber: | 6105793566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 04/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | UP004533-B | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.