Provider Demographics
NPI:1124067285
Name:HARKEN, BRIGITTE (CRNP)
Entity type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:
Last Name:HARKEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BRIGITTE
Other - Middle Name:
Other - Last Name:HANUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1101 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5393
Mailing Address - Country:US
Mailing Address - Phone:215-361-5010
Mailing Address - Fax:
Practice Address - Street 1:1101 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5393
Practice Address - Country:US
Practice Address - Phone:215-361-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008720363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ50482Medicare UPIN