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NPI Code Detail

MEDICARE: NELSON ANTHONY IANNUZZI CRNP

MEDICARE: NELSON ANTHONY IANNUZZI CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LC0200XCritical Care Medicine Nurse PractitionerSP007424PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SP007424OTHERPACRNP LICENSE

General Provider Information

NPI Number : 1225001142
Entity Type Code : Individual
Provider Name (Legal Business Name) : NELSON ANTHONY IANNUZZI CRNP
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE # 4903
Second Line :
City : DANVILLE
State : PA
Zip : 17822-9800
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 480 CENTRAL RD
Second Line :
City : BLOOMSBURG
State : PA
Zip : 17815-3121
Country : US
Telephone Number : 570-387-6150
Fax Number : 570-387-6185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 03/11/2025

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