Provider Demographics
NPI: | 1982025268 |
---|---|
Name: | KRUPKA, ALLISON (CRNP) |
Entity type: | Individual |
Prefix: | |
First Name: | ALLISON |
Middle Name: | |
Last Name: | KRUPKA |
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: | 232 AZALEA RD |
Mailing Address - Street 2: | |
Mailing Address - City: | BRODHEADSVILLE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18322-7702 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 443-383-9300 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 905 TOWER RD |
Practice Address - Street 2: | |
Practice Address - City: | BRISTOL |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19007-3116 |
Practice Address - Country: | US |
Practice Address - Phone: | 443-383-9300 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2014-01-03 |
Last Update Date: | 2024-03-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 26NJ00558400 | 363L00000X |
PA | SPO13756 | 363LF0000X |
PA | SP013448 | 363LA2200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |