MEDICARE: ALLISON KRUPKA CRNP

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	363L00000X	Nurse Practitioner	26NJ00558400	NJ
2	363LF0000X	Family Nurse Practitioner	SPO13756	PA
3	363LA2200X	Adult Health Nurse Practitioner	SP013448	PA

General Provider Information

NPI Number	:	1982025268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON KRUPKA CRNP

Provider Business Mailing Address
First Line	:	232 AZALEA RD
Second Line	:
City	:	BRODHEADSVILLE
State	:	PA
Zip	:	18322-7702
Country	:	US
Telephone Number	:	443-383-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 TOWER RD
Second Line	:
City	:	BRISTOL
State	:	PA
Zip	:	19007-3116
Country	:	US
Telephone Number	:	443-383-9300
Fax Number	:

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

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	03/27/2024

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