Provider Demographics
NPI:1396807731
Name:ALESI-HANNOLD, MARIA (CRNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ALESI-HANNOLD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:ALESI-MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:145 KING OF PRUSSIA RD STE 205
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4557
Mailing Address - Country:US
Mailing Address - Phone:610-902-4858
Mailing Address - Fax:610-902-2304
Practice Address - Street 1:145 KING OF PRUSSIA RD STE 205
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4557
Practice Address - Country:US
Practice Address - Phone:610-902-4858
Practice Address - Fax:610-902-2304
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP003213P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108317Medicare ID - Type Unspecified
PAQ76761Medicare UPIN