Healthcare Provider Details

I. General information

NPI: 1558813121
Provider Name (Legal Business Name): HEATHER OLVERA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SCOTLAND AVE
CHAMBERSBURG PA
17201-1451
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-6055
  • Fax: 717-217-4329
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP017338
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: