Provider Demographics
NPI:1447951777
Name:BURDO, MOIRIAH (CRNP)
Entity type:Individual
Prefix:
First Name:MOIRIAH
Middle Name:
Last Name:BURDO
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 1:440 MARYWATERSFORD RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2007
Mailing Address - Country:US
Mailing Address - Phone:610-945-7110
Mailing Address - Fax:
Practice Address - Street 1:825 OLD LANCASTER RD STE 320
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3235
Practice Address - Country:US
Practice Address - Phone:610-527-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027287363LP2300X, 363L00000X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology