Individual
ELLEN R SUPERDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
920 CHURCH ST, LEBANON, PA 17046-4656
(717) 272-2700
Mailing address
304 N WATER ST, LANCASTER, PA 17603-3374
(717) 735-6808
(717) 325-8057
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP020508
PA
Other
Enumeration date
09/23/2019
Last updated
03/04/2021
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