Healthcare Provider Details

I. General information

NPI: 1396261293
Provider Name (Legal Business Name): COLLEEN E PANZA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NORTHAMPTON ST
EASTON PA
18042-3154
US

IV. Provider business mailing address

416 SAUCON VIEW DR
BETHLEHEM PA
18015-5084
US

V. Phone/Fax

Practice location:
  • Phone: 445-448-1623
  • Fax: 307-248-1623
Mailing address:
  • Phone: 484-707-1737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018039
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018039
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: