Provider Demographics
NPI:1306863196
Name:SOSA, EILEEN PATRICIA (CRNP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:PATRICIA
Last Name:SOSA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:
Other - Last Name:O'DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:1ST FL
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2225
Mailing Address - Country:US
Mailing Address - Phone:717-544-2273
Mailing Address - Fax:717-544-8270
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:1ST FL
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2225
Practice Address - Country:US
Practice Address - Phone:717-544-2273
Practice Address - Fax:717-544-8270
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP005025B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP11764Medicare UPIN