Provider Demographics
NPI:1558518498
Name:DANESE, COLLEEN MARY (MSN)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:MARY
Last Name:DANESE
Suffix:
Gender:F
Credentials:MSN
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Mailing Address - Street 1:610 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:610-525-4966
Mailing Address - Fax:610-525-0874
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:484-227-3224
Practice Address - Fax:517-787-2922
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2023-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PARN547677367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered