Healthcare Provider Details

I. General information

NPI: 1619575768
Provider Name (Legal Business Name): KARA ELYSE CUNNINGHAM CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA ELYSE CRISWELL RN

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 HARRISBURG PIKE SUITE 200B
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

2150 HARRISBURG PIKE SUITE 200B
LANCASTER PA
17601-2644
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3539
  • Fax: 717-544-3229
Mailing address:
  • Phone: 717-544-3539
  • Fax: 717-544-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP022828
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN633646
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: