Healthcare Provider Details

I. General information

NPI: 1376213058
Provider Name (Legal Business Name): EDWARD C STENE CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2021
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

500 UNIVERSITY DR MC CA410
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-7299
  • Fax: 717-531-0089
Mailing address:
  • Phone: 717-531-5208
  • Fax: 717-531-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberSP024419
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: