MEDICARE: CAROLYN B HOLENCIK CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	040159	PA
2	367500000X	Certified Registered Nurse Anesthetist	RN258898L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00146818	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1437115	OTHER	PA	HIGHMARK BLUE SHIELD
2	50043999	OTHER	PA	CAPITAL BLUE CROSS
4	S75535	OTHER	PA	HELATHAMERICA

General Provider Information

NPI Number	:	1528067634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN B HOLENCIK CRNA

Provider Business Mailing Address
First Line	:	4300 LONDONDERRY RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5317
Country	:	US
Telephone Number	:	717-782-5118
Fax Number	:	717-782-5854

Provider Business Practice Location Address
First Line	:	4300 LONDONDERRY RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5317
Country	:	US
Telephone Number	:	717-782-5118
Fax Number	:	717-782-5854

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	12/17/2025

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Directions to “ CAROLYN B HOLENCIK CRNA” Practice Location

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