Provider Demographics
NPI:1154812147
Name:NOWAKOWSKI, ALISHA JO (CRNP)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:JO
Last Name:NOWAKOWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HUFF AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5484
Mailing Address - Country:US
Mailing Address - Phone:724-836-4662
Mailing Address - Fax:724-836-2876
Practice Address - Street 1:40 HUFF AVENUE EXT
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5484
Practice Address - Country:US
Practice Address - Phone:724-836-4662
Practice Address - Fax:724-836-2876
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018892363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care