Provider Demographics
NPI:1497854731
Name:NEFF, ELLEN FAY (CRNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:FAY
Last Name:NEFF
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 1:701 FOULK RD
Mailing Address - Street 2:STE 1A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3733
Mailing Address - Country:US
Mailing Address - Phone:610-869-3620
Mailing Address - Fax:
Practice Address - Street 1:1011 W BALTIMORE PIKE
Practice Address - Street 2:SUITE 301
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9446
Practice Address - Country:US
Practice Address - Phone:610-869-3620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004979B363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG09367Medicare UPIN
075600Medicare ID - Type Unspecified