Provider Demographics
NPI:1508935487
Name:DENISON, LOREN EILEEN (MS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LOREN
Middle Name:EILEEN
Last Name:DENISON
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 EMANDAN LN
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8402
Mailing Address - Country:US
Mailing Address - Phone:610-256-7351
Mailing Address - Fax:
Practice Address - Street 1:30 MEDICAL CENTER BLVD
Practice Address - Street 2:SUIT 304
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3955
Practice Address - Country:US
Practice Address - Phone:610-447-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052879363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical