Provider Demographics
NPI:1669726907
Name:O'HARA, DENISE (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:O'HARA
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 MARYLAND RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1749
Mailing Address - Country:US
Mailing Address - Phone:215-957-9250
Mailing Address - Fax:215-957-9254
Practice Address - Street 1:2325 MARYLAND RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1749
Practice Address - Country:US
Practice Address - Phone:215-957-9250
Practice Address - Fax:215-957-9254
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012293363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health