Provider Demographics
NPI:1770512386
Name:ROY, DENISE (CNM)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 REDTAIL RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1844
Mailing Address - Country:US
Mailing Address - Phone:610-630-3273
Mailing Address - Fax:
Practice Address - Street 1:918 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2502
Practice Address - Country:US
Practice Address - Phone:610-525-6086
Practice Address - Fax:610-525-1846
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008178L176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4615720OtherUSHC PROFESSIONAL
PA9171253OtherPRIVATE HEALTHCARE SYSTEM
PA89824OtherBLUE SHIELD PROFESSIONAL
PA1835550Medicaid
PA290891OtherMAMSI
PA01835550-03OtherAMERICHOICE-MA
PA89824OtherBLUE CROSS PPO
PA89824OtherKEYSTONE PROFESSIONAL
PAP003418OtherCHAMPUS
PA31021OtherAETNA PROFESSIONAL
PA89824OtherPERSONAL CHOICE PROF
PA62127000OtherBLUE CROSS HMO
PAX34384OtherAMERIHEALTH ADMIN