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General NPI Number Information
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NPI Number | 1538937909
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Entity Type | Individual
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Provider Name | KRISTEN M OMLOR
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Gender | Female
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 125 LOGANS FERRY RD
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City | LOWER BURRELL
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State | PA
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Zip | 15068-2048
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Country | US
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Telephone | 866-419-1693
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Fax |
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Provider Business Mailing Address
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Address Line | 13911 HARVIE CT
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City | NORTH HUNTINGDON
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State | PA
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Zip | 15642-1656
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Country | US
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Telephone | 412-418-6999
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Fax |
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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 | RN598636
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP028960
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License Number State | PA
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