Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP020990 | PA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP020990 | PA |
NPI | 1396202537 |
---|---|
Provider Name | Alan Hyneman |
First Address | Reading, PA 19612-3579 |
Second Address | West Reading, PA 19611-2143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2019 |
Last Update Date | 05/12/2019 |