ELLEN R SUPERDOCK (NPI# 1497306336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497306336 |
| Entity Type | Individual |
| Full Name | ELLEN R SUPERDOCK |
| Credential | CRNP |
| Practice Address |
435 S Kinzer Ave Ste 6 New Holland PA 17557-8706 |
| Mailing Address |
584 Springville Rd New Holland PA 17557-9564 |
| Practice Telephone | 7173512400 |
| Mailing Telephone | 7173544711 |
| Mailing Fax Number | 7173540284 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP020508 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
435 S KINZER AVE STE 6 |
| City | NEW HOLLAND |
| State | PA |
| Zip Code | 17557-8706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296448 | Buehler Family Dental, P.C. | Dentist | 912 W Main Street, Suite 404, New Holland, PA 17557 | 2019-10-11 |
| 1972012318 | Andrews Eye Corporation | Clinic/Center | 117 West Main Street, New Holland, PA 17557 | 2017-09-28 |
| 1528295961 | Tuyet-nga Q Vu | Family Medicine | 676 East Main Street, New Holland, PA 17557 | 2009-06-12 |
| 1396922613 | T W Ponessa and Associates Counseling Services Inc | Community/Behavioral Health | 126 Eastern School Road, Earl Township, PA 17557 | 2008-01-29 |
| 1326252461 | William M Sabo | Dentist | 912 West Main Street, Suite 202, New Holland, PA 17557 | 2007-05-09 |
| 1699864934 | Daniel C West | Dentist | 650 East Main Street, New Holland, PA 17557 | 2006-10-12 |
| 1114010758 | Sherri Beth Newill | Specialist/Technologist | 669 E Main Street, New Holland, PA 17557 | 2006-10-02 |
| 1487668620 | James Michael Amor | Dentist | 566 East Main Street, New Holland, PA 17557 | 2006-07-27 |
| 1841776127 | Lisa Ann Nolan | Nurse Practitioner | 584 Springville Rd, New Holland, PA 17557 | 2018-07-19 |
| 1376038505 | Stephanie K Glick | Nurse Practitioner | 435 S Kinzer Ave, New Holland, PA 17557 | 2018-06-29 |
| Find all providers in zip 17557 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962470005 | Dorcas L Riehl | Nurse Practitioner | 584 Springville Rd, New Holland, PA 17557-9564 | 2006-03-14 |
| 1639710650 | Justine Mccracken | Nurse Practitioner | 676 E Main St, New Holland, PA 17557-1426 | 2019-10-01 |
| 1376038505 | Stephanie K Glick | Nurse Practitioner | 435 S Kinzer Ave, New Holland, PA 17557 | 2018-06-29 |
| 1629500970 | Jessica Ruth Meyer | Nurse Practitioner | 584 Springville Rd, New Holland, PA 17557-9564 | 2017-03-28 |
| 1184077810 | Megan E Jones | Nurse Practitioner | 435 S Kinzer Ave, New Holland, PA 17557-8706 | 2016-07-18 |
| 1750637062 | Stacey Burke Brennan | Nurse Practitioner | 584 Springville Rd, New Holland, PA 17557-9564 | 2012-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912170 | Kaley Elizabeth Barrett | Nurse Practitioner | 418 Edgewood Dr, Lebanon, PA 17042-9109 | 2020-11-04 |
| 1891395406 | Eimy Aguilar | Nurse Practitioner | 18 Descartes Dr, Lancaster, PA 17603-8861 | 2020-11-01 |
| 1134729775 | Jacqueline A Ouma | Nurse Practitioner | 4530 Clairton Blvd, Pittsburgh, PA 15236-2112 | 2020-10-30 |
| 1932709912 | Sheri Lynn Tittelmayer | Nurse Practitioner | 1012 Rozel Ave, Southampton, PA 18966-4130 | 2020-10-28 |
| 1346849197 | Alexander F Talarico | Nurse Practitioner | 576 Broad St, Emmaus, PA 18049-3856 | 2020-10-22 |
| 1255930129 | Patrick A Foster | Nurse Practitioner | 3332 Eisenbrown Rd, Reading, PA 19605-1412 | 2020-10-22 |
| 1033718051 | Charlene Martin Wolfgang | Nurse Practitioner | 806 Megan Dr, Cranberry Twp, PA 16066-7422 | 2020-10-21 |
| 1750980728 | Jamie Simpson | Nurse Practitioner | 618 Rachelle Ct, Latrobe, PA 15650-4731 | 2020-10-21 |
| 1124627138 | Ashley G Dillard | Nurse Practitioner | 5447 Stanton Ave, Pittsburgh, PA 15206-2518 | 2020-10-21 |
| 1831798867 | Elena Khlobystova | Nurse Practitioner | 16 Carriage House Dr, Southampton, PA 18966-2225 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | NEW HOLLAND |
| Zip Code | 17557 |
Please comment or provide details below to improve the information on ELLEN R SUPERDOCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.