Healthcare Provider Details

I. General information

NPI: 1669998233
Provider Name (Legal Business Name): DENISE LYNN ELDRIDGE CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N 7TH ST
CHAMBERSBURG PA
17201-1720
US

IV. Provider business mailing address

5 SANDMAN CT
FLEETWOOD PA
19522-8992
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-2613
  • Fax:
Mailing address:
  • Phone: 484-269-7158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP017793
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number289267
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP017793
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: