Healthcare Provider Details

I. General information

NPI: 1134678246
Provider Name (Legal Business Name): NELS REMMEN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2016
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1065
US

IV. Provider business mailing address

PO BOX 5520
BETHLEHEM PA
18015-0520
US

V. Phone/Fax

Practice location:
  • Phone: 610-954-5810
  • Fax: 610-954-5480
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN645295
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: