Healthcare Provider Details

I. General information

NPI: 1629643051
Provider Name (Legal Business Name): KENNETH WOJNO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 LAKEMONT PARK BLVD STE 100
ALTOONA PA
16602-5967
US

IV. Provider business mailing address

400 LAKEMONT PARK BLVD STE 100
ALTOONA PA
16602-5967
US

V. Phone/Fax

Practice location:
  • Phone: 814-944-4722
  • Fax: 814-266-2880
Mailing address:
  • Phone: 814-944-4722
  • Fax: 814-266-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN328594L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: