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General NPI Number Information
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NPI Number | 1619476546
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Entity Type | Individual
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Provider Name | MARIA-ELISA KATRINA JAVIER CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 570-271-6211
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 1ST ST
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City | DANVILLE
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State | PA
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Zip | 17821-1261
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Country | US
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Telephone | 717-406-7031
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN611712
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License Number State | PA
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