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General NPI Number Information
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NPI Number | 1427601657
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Entity Type | Individual
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Provider Name | ELIZABETH FULLERTON-DUMMIT
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Gender | Female
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Dates
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Enumeration Date | 07/17/2019
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 1355 OLD YORK RD STE 301
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City | ABINGTON
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State | PA
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Zip | 19001-3413
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Country | US
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Telephone | 215-886-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 78 E CHURCH LN
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2213
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Country | US
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Telephone | 267-216-6642
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-144112
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License Number State | PA
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