Provider Demographics
NPI:1326717711
Name:DENNIS, VIRGINIA K (FNP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:K
Last Name:DENNIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BERKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1354
Mailing Address - Country:US
Mailing Address - Phone:215-910-9003
Mailing Address - Fax:
Practice Address - Street 1:241 BERKLEY AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1354
Practice Address - Country:US
Practice Address - Phone:215-910-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF08210019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily