Provider Demographics
NPI:1215381702
Name:DOOLEY, NANCY M
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E MORELAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3562
Mailing Address - Country:US
Mailing Address - Phone:267-385-5538
Mailing Address - Fax:267-437-3176
Practice Address - Street 1:10 E MORELAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3562
Practice Address - Country:US
Practice Address - Phone:267-437-3163
Practice Address - Fax:267-437-3176
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016175363LA2200X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology