Healthcare Provider Details

I. General information

NPI: 1609880814
Provider Name (Legal Business Name): ELIZABETH C SIGMUND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 MAIN ST
EAST PETERSBURG PA
17520-1513
US

IV. Provider business mailing address

5665 MAIN ST
EAST PETERSBURG PA
17520-1513
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-7011
  • Fax: 717-569-8694
Mailing address:
  • Phone: 717-569-7011
  • Fax: 717-569-8694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTP005399B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: