Healthcare Provider Details

I. General information

NPI: 1063307858
Provider Name (Legal Business Name): ANNTOINETTE ROMANOWSKI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 PIERCE ST
KINGSTON PA
18704-5731
US

IV. Provider business mailing address

PO BOX 1885
KINGSTON PA
18704-0885
US

V. Phone/Fax

Practice location:
  • Phone: 570-714-3333
  • Fax: 570-338-3993
Mailing address:
  • Phone: 570-288-8881
  • Fax: 570-288-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP033072
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP033072
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: