Provider Demographics
NPI:1780820274
Name:ELLISON, DENISE LOUISE (CPNP)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LOUISE
Last Name:ELLISON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:4 LENFEST WEST
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-4094
Mailing Address - Fax:215-481-8448
Practice Address - Street 1:1400 OLD YORK RD STE D
Practice Address - Street 2:CRS NEWBORN CENTER
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-2600
Practice Address - Country:US
Practice Address - Phone:215-481-6606
Practice Address - Fax:215-576-0410
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008336363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics