Healthcare Provider Details

I. General information

NPI: 1548035173
Provider Name (Legal Business Name): GINA LUKAS PLONSKI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 POTTSTOWN AVE
PENNSBURG PA
18073-1423
US

IV. Provider business mailing address

420 POTTSTOWN AVE
PENNSBURG PA
18073-1423
US

V. Phone/Fax

Practice location:
  • Phone: 215-679-9321
  • Fax:
Mailing address:
  • Phone: 215-679-9321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP027927
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: