MRS. CHRISTINE NIERODA CLANCY CRNP NPI 1487677084

NPI Information

NPI: 1487677084
Provider Name: MRS. CHRISTINE NIERODA CLANCY, CRNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: JEFFERSON UNIVERSITY PHYSICIANS

PECOS Registration: Yes

Address:
211 S. 9TH STREET
SUITE 600
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 955-1925
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MRS. Christine Nieroda Clancy, CRNP is a gerontology nurse practitioner in Philadelphia, PA with 27 years of experience. MRS. Christine Nieroda Clancy, CRNP NPI is 1487677084. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

211 S. 9TH STREET
SUITE 600
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 955-1925
Fax: (215) 928-3160

The NPI 1487677084 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 10/25/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	VP004645C	PENNSYLVANIA	No
2	363LG0600X	Nurse Practitioner	Gerontology	VP004645C	PENNSYLVANIA	Yes
3	363LP2300X	Nurse Practitioner	Primary Care	VP004645C	PENNSYLVANIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	103075213	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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