Healthcare Provider Details

I. General information

NPI: 1730296757
Provider Name (Legal Business Name): SHARLENE R MOYER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SIXTH AND SPRUCE STREETS
READING PA
19612-6052
US

IV. Provider business mailing address

SIXTH AND SPRUCE STREETS
READING PA
19612-6052
US

V. Phone/Fax

Practice location:
  • Phone: 610-988-5089
  • Fax: 610-988-5135
Mailing address:
  • Phone: 610-988-5089
  • Fax: 610-988-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN201667L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: