Provider Demographics
NPI:1396170320
Name:ROSTOCKI, ALLISON LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LYNN
Last Name:ROSTOCKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LYNN
Other - Last Name:HUDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-0719
Mailing Address - Country:US
Mailing Address - Phone:412-457-0175
Mailing Address - Fax:412-457-0179
Practice Address - Street 1:128 W 14TH ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-3266
Practice Address - Country:US
Practice Address - Phone:570-455-7677
Practice Address - Fax:570-455-7627
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN604756163W00000X
PAA0713058363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse