1982692703 NPI number — SCARLET B. WILLIAMS CRNP

Table of content: SCARLET B. WILLIAMS CRNP (NPI 1982692703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982692703 NPI number — SCARLET B. WILLIAMS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
SCARLET
Provider Middle Name:
B.
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:
LICHTENWALNER
Provider Other First Name:
SCARLET
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982692703
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 CETRONIA RD
Provider Second Line Business Mailing Address:
STE 303
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-9168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-973-6200
Provider Business Mailing Address Fax Number:
866-644-0894

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 CETRONIA RD
Provider Second Line Business Practice Location Address:
STE 303
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-9168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-973-6200
Provider Business Practice Location Address Fax Number:
866-644-0894
Provider Enumeration Date:
10/06/2005

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:  RN320366L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: UP006586B , 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: P3452605 . This is a "OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1389290 . This is a "KHP CENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1392874 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02273202 . This is a "CAP BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com