Provider Demographics
NPI:1467486704
Name:DUNHAM, MARGUERITE (CRNP)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:
Other - Last Name:SHEIPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-807-8235
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP006607B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA131095OtherHIGHMARK BLUE SHIELD
PA500029734OtherRAILROAD MEDICARE
PAP40844Medicare UPIN
PA500029734OtherRAILROAD MEDICARE