Healthcare Provider Details

I. General information

NPI: 1871938944
Provider Name (Legal Business Name): NANCY YABLONSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 E TAYLOR ST
TAYLOR PA
18517-1832
US

IV. Provider business mailing address

148 E TAYLOR ST
TAYLOR PA
18517-1832
US

V. Phone/Fax

Practice location:
  • Phone: 570-562-1352
  • Fax:
Mailing address:
  • Phone: 570-562-1352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN140783L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: