1467792333 NPI number — DONNA M OSWANDEL CRNP

Table of content: DONNA M OSWANDEL CRNP (NPI 1467792333)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467792333 NPI number — DONNA M OSWANDEL CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSWANDEL
Provider First Name:
DONNA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OSWANDEL
Provider Other First Name:
DONNA
Provider Other Middle Name:
ZEIDERS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1467792333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 858
Provider Second Line Business Mailing Address:
MAIL CODE CA410
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033-0858
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-243-1455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 HOPE DRIVE
Provider Second Line Business Practice Location Address:
SUITES 202/ 204
Provider Business Practice Location Address City Name:
HERSHEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17033-2086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-243-1455
Provider Business Practice Location Address Fax Number:
717-531-4375
Provider Enumeration Date:
02/28/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN512229L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: SP012837 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102896849 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".