Healthcare Provider Details

I. General information

NPI: 1417177767
Provider Name (Legal Business Name): TAUNIA KRANTZ CERESINI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 LAKE ST
EPHRATA PA
17522-2415
US

IV. Provider business mailing address

136 LAKE ST
EPHRATA PA
17522-2415
US

V. Phone/Fax

Practice location:
  • Phone: 717-721-7718
  • Fax: 717-721-7726
Mailing address:
  • Phone: 717-721-7718
  • Fax: 717-721-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP-003238-B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: