Provider Demographics
NPI:1215051701
Name:ALTENOR, ROBERTA ALDERFER (RN,MSN)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ALDERFER
Last Name:ALTENOR
Suffix:
Gender:F
Credentials:RN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 AZALEA DRIVE
Mailing Address - Street 2:DPW ADMINISTRATION BUILDING-DGS ANNEX COMPLEX
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3593
Mailing Address - Country:US
Mailing Address - Phone:717-346-9563
Mailing Address - Fax:717-787-5394
Practice Address - Street 1:20 AZALEA DRIVE
Practice Address - Street 2:DPW ADMINISTRATION BUILDING-DGS ANNEX COMPLEX
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3593
Practice Address - Country:US
Practice Address - Phone:717-346-9563
Practice Address - Fax:717-787-5394
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN243407L163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator