MEDICARE: DONNA DELOWERY 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
1	363LA2200X	Adult Health Nurse Practitioner	VP003310C	PA

General Provider Information

NPI Number	:	1831178789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA DELOWERY CRNP

Provider Business Mailing Address
First Line	:	2600 BELMONT AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2799
Country	:	US
Telephone Number	:	215-878-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 BELMONT AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2799
Country	:	US
Telephone Number	:	215-878-5600
Fax Number	:

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	12/08/2015

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