Healthcare Provider Details

I. General information

NPI: 1912441791
Provider Name (Legal Business Name): MS. ELO PRANNO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W BEAVER ST SUITE 2
MERCER PA
16137-1547
US

IV. Provider business mailing address

101 W BEAVER ST SUITE 2
MERCER PA
16137-1547
US

V. Phone/Fax

Practice location:
  • Phone: 724-699-6538
  • Fax: 855-874-5395
Mailing address:
  • Phone: 724-699-6538
  • Fax: 855-874-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW019324
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: