Individual provider · Type 1 NPI

Charles Pankow Jr., CRNP

Nurse Practitioner · Philadelphia, PA

NPI number 1174366884 Active

Practice location

330 South Ninth Street
Philadelphia, PA 19107-6103

Fax (215) 829-6606

Other practice locations

  • 13685 Doctors Way Ste 350, Fort Myers, FL 33912-4347 · (239) 343-3800
  • 3132 Royal Gardens Ave, Fort Myers, FL 33916-4580 · (239) 994-3350

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner 363LA2100XAPRN11033483 (FL)
Nurse Practitioner Primary 363L00000XSP034276 (PA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

8 other providers at this address

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About NPI 1174366884

Charles Pankow Jr., CRNP's National Provider Identifier is 1174366884, issued on Jun 18, 2024. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Philadelphia, PA. The record was last updated on Feb 18, 2026.