Provider Demographics
NPI:1487821914
Name:CHARBONNEAU, DENISE (CRNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:CHARBONNEAU
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 1:11279 PERRY HWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9381
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:205 MILLERS RUN RD
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1348
Practice Address - Country:US
Practice Address - Phone:412-373-1717
Practice Address - Fax:412-856-8460
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP005088D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics