Healthcare Provider Details

I. General information

NPI: 1790891646
Provider Name (Legal Business Name): VICKI A OHLER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 N 3RD ST
HARRISBURG PA
17110-2001
US

IV. Provider business mailing address

118 WASHINGTON ST
HARRISBURG PA
17104-1677
US

V. Phone/Fax

Practice location:
  • Phone: 717-782-4650
  • Fax: 717-782-4665
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN179185L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberVP004240D
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: