MEDICARE: CAROLINE ELLIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	SP023078	PA
2	363LA2200X	Adult Health Nurse Practitioner	SP023078	PA

General Provider Information

NPI Number	:	1467045625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE ELLIS

Provider Business Mailing Address
First Line	:	3803 W CHESTER PIKE STE 160
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2336
Country	:	US
Telephone Number	:	484-476-2580
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3450
Country	:	US
Telephone Number	:	484-476-2580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	02/09/2026

Similar Medicare Providers

1174595532 — DR. GERALD J MARKS MD
Practice Location Address:

100 E LANCASTER AVE , SUITE 330 LANKENAU MOB WEST
WYNNEWOOD, PA
19096-3450

Practice Phone: 610-645-9093
Practice Fax: 610-645-9476

1720957038 — JADE BRAZELL
Practice Location Address:

100 E LANCASTER AVE , THE HEART PAVILLION MEZZANINE LEVEL
WYNNEWOOD, PA
19096-3450

Practice Phone: 484-476-1000
Practice Fax: 484-476-9000

1598300055 — ELIANA RAE KATZ PA-C
Practice Location Address:

100 E LANCASTER AVE , THE HEART PAVILLION MEZZANINE LEVEL
WYNNEWOOD, PA
19096-3450

Practice Phone: 484-476-1000
Practice Fax: 484-476-9000

1245335629 — MAIN LINE HOSPITALS, INC.
Practice Location Address:

100 E LANCASTER AVE
WYNNEWOOD, PA
19096-3450

Practice Phone: 610-645-2000
Practice Fax:

1760845028 — JEREMY CHANAN BOXER M.D.
Practice Location Address:

100 E LANCASTER AVE
WYNNEWOOD, PA
19096-3450

Practice Phone: 484-476-2000
Practice Fax:

1902193311 — DR. ROBERT HENRY BECKER M.D.
Practice Location Address:

100 E LANCASTER AVE , SUITE 560 LANKENAU MOB EAST
WYNNEWOOD, PA
19096-3450

Practice Phone: 610-649-1922
Practice Fax: 610-649-2121

Directions to “ CAROLINE ELLIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.