Provider Demographics
NPI:1346589801
Name:JOHN W ROSENCRANS CRNP, PC
Entity Type:Organization
Organization Name:JOHN W ROSENCRANS CRNP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENCRANS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:570-288-1258
Mailing Address - Street 1:395 OSCEOLA AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5118
Mailing Address - Country:US
Mailing Address - Phone:570-288-1258
Mailing Address - Fax:
Practice Address - Street 1:395 OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5118
Practice Address - Country:US
Practice Address - Phone:570-288-1258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005021B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA078322Medicare UPIN