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NPI Code Detail

MEDICARE: DONNALEE M DALE AGNP-C

MEDICARE: DONNALEE M DALE AGNP-C
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
1363L00000XNurse Practitioner26NJ14906900NJ
2363L00000XNurse PractitionerSP027552PA

General Provider Information

NPI Number : 1073206603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNALEE M DALE AGNP-C
Provider Business Mailing Address
First Line : 3702 MECHANICSVILLE PL
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19154-2011
Country : US
Telephone Number : 267-408-7514
Fax Number :
Provider Business Practice Location Address
First Line : 3702 MECHANICSVILLE PL
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19154-2011
Country : US
Telephone Number : 267-408-7514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2023
Last Update Date : 07/12/2024

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Directions to “ DONNALEE M DALE AGNP-C” Practice Location

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