Healthcare Provider Details

I. General information

NPI: 1720230337
Provider Name (Legal Business Name): ISABELITA ANNULYSSE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MARIA ISABELITA AVISO

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 NAZARETH RD SUITE 301
EASTON PA
18045-8338
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 610-258-2826
  • Fax: 610-258-9377
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP009982
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009982
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: