Provider Demographics
NPI:1891346326
Name:DENNY, PHILIP ISRAEL (NP)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:ISRAEL
Last Name:DENNY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 742921
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2921
Mailing Address - Country:US
Mailing Address - Phone:804-288-2742
Mailing Address - Fax:804-288-9053
Practice Address - Street 1:7607 FOREST AVE STE 300
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-4913
Practice Address - Country:US
Practice Address - Phone:804-288-2742
Practice Address - Fax:804-288-9053
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178056363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care