Healthcare Provider Details

I. General information

NPI: 1700871712
Provider Name (Legal Business Name): YASMEEN NATALE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MORGAN HWY SUITE 4
SCRANTON PA
18508-2641
US

IV. Provider business mailing address

5 MORGAN HWY SUITE 4
SCRANTON PA
18508-2641
US

V. Phone/Fax

Practice location:
  • Phone: 570-344-3788
  • Fax: 570-969-9280
Mailing address:
  • Phone: 570-344-3788
  • Fax: 570-969-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberTP-005717-B
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier103062858-0001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier123456
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CARE HMO (FPH)
# 3
Identifier029358
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CARE
# 4
Identifier50076558
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAPITAL BLUE CROSS
# 5
Identifier500007758
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerRAILROAD MEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: