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NPI Code Detail

MEDICARE: MRS. ELLEN M ELINE CRNP

MEDICARE: MRS. ELLEN M ELINE CRNP
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
1363LA2200XAdult Health Nurse PractitionerR124819MD
2363LA2200XAdult Health Nurse PractitionerSP010305PA

General Provider Information

NPI Number : 1508868829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELLEN M ELINE CRNP
Provider Business Mailing Address
First Line : 155 STONEGATE DR
Second Line :
City : MC MURRAY
State : PA
Zip : 15317-2766
Country : US
Telephone Number : 724-260-0129
Fax Number :
Provider Business Practice Location Address
First Line : 300 HALKET ST
Second Line : MAGEE WOMEN'S HOSPITAL, UPP - DEPARTMENT OF OB/GYN
City : PITTSBURGH
State : PA
Zip : 15213-3108
Country : US
Telephone Number : 412-641-5388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 05/20/2010

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