Provider Demographics
NPI:1588159164
Name:DUFFY, MONICA (CRNP, NP-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:CRNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19074-1109
Mailing Address - Country:US
Mailing Address - Phone:484-716-0297
Mailing Address - Fax:
Practice Address - Street 1:634 SPROUL ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4208
Practice Address - Country:US
Practice Address - Phone:610-872-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP018944OtherSTATE BOARD OF NURSING