Provider Demographics
NPI:1710450317
Name:O'DONNELL, MADELINE SUSAN (CRNP)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:SUSAN
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:CORSON-O'DONNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:2010 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951
Mailing Address - Country:US
Mailing Address - Phone:215-380-5753
Mailing Address - Fax:
Practice Address - Street 1:680 BLAIR MILL RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044
Practice Address - Country:US
Practice Address - Phone:215-380-5753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily