Provider Demographics
NPI:1215994157
Name:MCELWAIN, CATHERINE (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MCELWAIN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 MARKET ST
Mailing Address - Street 2:STE 105B
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3315
Mailing Address - Country:US
Mailing Address - Phone:303-312-2217
Mailing Address - Fax:
Practice Address - Street 1:3401 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3318
Practice Address - Country:US
Practice Address - Phone:215-220-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89532538Medicaid
COF72930Medicare PIN