Provider Demographics
NPI:1083022289
Name:WOMER, SANDRINA (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDRINA
Middle Name:
Last Name:WOMER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SANDRINA
Other - Middle Name:
Other - Last Name:GUSMEROTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:1020 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:JERSEY SHORE
Practice Address - State:PA
Practice Address - Zip Code:17740-1729
Practice Address - Country:US
Practice Address - Phone:570-753-8077
Practice Address - Fax:570-398-7039
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013973363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner