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General NPI Number Information
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NPI Number | 1346290038
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Entity Type | Individual
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Provider Name | JOELLEN GITTENS CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 743 JEFFERSON AVE SUITE 206
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City | SCRANTON
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State | PA
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Zip | 18510-1635
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Country | US
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Telephone | 570-341-9818
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Fax | 570-341-9950
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Provider Business Mailing Address
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Address Line | 743 JEFFERSON AVE SUITE 206
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City | SCRANTON
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State | PA
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Zip | 18510-1635
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Country | US
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Telephone | 570-341-9818
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Fax | 570-341-9950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN232769L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | UP003033C
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | UP003033C
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License Number State | PA
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