Provider Demographics
NPI:1598863128
Name:DOMANN, ELIZABETH VONRUDEN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:VONRUDEN
Last Name:DOMANN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1980 S EASTON RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-7103
Mailing Address - Country:US
Mailing Address - Phone:215-348-1310
Mailing Address - Fax:215-348-8615
Practice Address - Street 1:1980 SOUTH EASTON ROAD
Practice Address - Street 2:SUITE 230
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2250
Practice Address - Country:US
Practice Address - Phone:215-348-1310
Practice Address - Fax:215-348-8615
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP004654B163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP27823Medicare UPIN