Healthcare Provider Details

I. General information

NPI: 1467020495
Provider Name (Legal Business Name): NAOMI REPLOGLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 COMMERCE DR # 166
WYOMISSING PA
19610-3313
US

IV. Provider business mailing address

96 COMMERCE DR # 166
WYOMISSING PA
19610-3313
US

V. Phone/Fax

Practice location:
  • Phone: 307-630-7076
  • Fax:
Mailing address:
  • Phone: 307-630-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11013696
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP023957
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11013696
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: