Healthcare Provider Details

I. General information

NPI: 1154722148
Provider Name (Legal Business Name): KRISTEN ASHLEY SYKORA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S CEDAR CREST BLVD STE 400
ALLENTOWN PA
18103-6224
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-6555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013894
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: