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General NPI Number Information
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NPI Number | 1902314180
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Entity Type | Individual
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Provider Name | ALICIA E NOVAK
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Gender | Female
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 221 RIVER ST
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City | OLYPHANT
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State | PA
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Zip | 18447-1475
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Country | US
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Telephone | 570-383-3636
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Fax | 570-383-3638
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Provider Business Mailing Address
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Address Line | 221 RIVER ST
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City | OLYPHANT
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State | PA
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Zip | 18447-1475
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Country | US
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Telephone | 570-383-3636
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP017816
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | MN4693847
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP017816
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License Number State | PA
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