Provider Demographics
NPI:1346271236
Name:KISER, DONNA (CRNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:KISER
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 1:4131 OREGON PIKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-9550
Mailing Address - Country:US
Mailing Address - Phone:717-859-5161
Mailing Address - Fax:717-859-5169
Practice Address - Street 1:4131 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17508
Practice Address - Country:US
Practice Address - Phone:717-859-1123
Practice Address - Fax:717-859-2898
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005087B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50051190OtherCAPITAL BLUE CROSS
1915954OtherHIGHMARK/FREEDOM BLUE
1915954OtherHIGHMARK/FREEDOM BLUE
PA013847UFWMedicare ID - Type Unspecified