Provider Demographics
NPI:1497848352
Name:ABENDROTH, MARY ELLEN FRANCES (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MARY ELLEN
Middle Name:FRANCES
Last Name:ABENDROTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1460
Mailing Address - Country:US
Mailing Address - Phone:302-644-9080
Mailing Address - Fax:302-644-9088
Practice Address - Street 1:431 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1460
Practice Address - Country:US
Practice Address - Phone:302-644-9080
Practice Address - Fax:302-644-9088
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH0030839363LA2200X
DELH0000167363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEQ11268Medicare UPIN