Provider Demographics
NPI:1891416871
Name:COUNTIE, PATRICIA ANN JOHNSTONE (CRNP, RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN JOHNSTONE
Last Name:COUNTIE
Suffix:
Gender:F
Credentials:CRNP, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 E SERGEANT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1728
Mailing Address - Country:US
Mailing Address - Phone:603-548-8025
Mailing Address - Fax:
Practice Address - Street 1:825 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2843
Practice Address - Country:US
Practice Address - Phone:888-227-3898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0070725163WP0808X
PARN726827163WP0808X, 163WP0808X
NJ26NR24480600163WP0808X
MARN2337891163WP0808X, 363LP0808X
PASP026417363LP0808X
DEL8-0010377363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health