Healthcare Provider Details

I. General information

NPI: 1760412027
Provider Name (Legal Business Name): EILEEN YOUNKER BSN CRRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S RIVER ST C/O ADULT SERVICES UNLIMITED T/A RIVERSIDE REHAB
PLAINS PA
18705-1137
US

IV. Provider business mailing address

220 S RIVER ST C/O ADULT SERVICES UNLIMITED T/A RIVERSIDE REHAB
PLAINS PA
18705-1137
US

V. Phone/Fax

Practice location:
  • Phone: 570-824-3444
  • Fax: 570-824-4021
Mailing address:
  • Phone: 570-824-3444
  • Fax: 570-824-4021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberRN328506L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: