Provider Demographics
NPI:1811962566
Name:DUFORT, CLAIRE HUNTER (CRNP)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:HUNTER
Last Name:DUFORT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3224
Mailing Address - Country:US
Mailing Address - Phone:610-326-7820
Mailing Address - Fax:610-326-4068
Practice Address - Street 1:1555 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3224
Practice Address - Country:US
Practice Address - Phone:610-326-7820
Practice Address - Fax:610-326-4068
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP003521D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
S60850Medicare UPIN