Healthcare Provider Details

I. General information

NPI: 1598162430
Provider Name (Legal Business Name): JOANNE FLEURY ALLADIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 01/09/2021
Certification Date: 01/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SOUTH FRONT STREET 5TH FLOOR BMA
HARRISBURG PA
17104-1619
US

IV. Provider business mailing address

205 S FRONT ST FL 5
HARRISBURG PA
17104-1619
US

V. Phone/Fax

Practice location:
  • Phone: 717-231-8360
  • Fax: 717-231-8358
Mailing address:
  • Phone: 717-231-8360
  • Fax: 717-231-8358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP014548
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP014548
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: