Healthcare Provider Details

I. General information

NPI: 1457725061
Provider Name (Legal Business Name): COLLEEN OKONIESKI MSN, CRNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N PROGRESS AVE
HARRISBURG PA
17109-1014
US

IV. Provider business mailing address

550 N PROGRESS AVE
HARRISBURG PA
17109-1014
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015483
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP015483
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: