Provider Demographics
NPI:1215924584
Name:ADAMS, NANCY A (CRNA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:2545 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7300
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN268321L163W00000X
PA040489367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1343147OtherFIRST PRIORITY
PA2035814000OtherINDEP. BLUE CROSS
PA03221101OtherCAPITAL ADVANTAGE
PA1342147OtherKHP CENTRAL
PA1343147OtherHIGHMARK
PA1544235OtherGATEWAY
PA1027801190001Medicaid
PA82827OtherGEISINGER
PA9605463OtherAETNA
PA11743994OtherCAQH
PA1544235OtherGATEWAY
PAS48532Medicare UPIN
PA005391QCYMedicare PIN