Provider Demographics
NPI:1780679621
Name:EPSER, ELEANOR ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ANN
Last Name:EPSER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:2545 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7300
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN288245L163W00000X
PA049883367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1585089OtherGATEWAY
PA11754790OtherCAQH
PA1343397OtherFIRST PRIORITY
PA03222301OtherCAPITAL ADVANTAGE
PA9453198OtherAETNA
PA1020828770002Medicaid
PA1343397OtherHIGHMARK
PA1343397OtherKHKP CENTRAL
PA2036045000OtherINDEP. BLUE CROSS
PA82840OtherGEISINGER
PA430070466Medicare PIN
PA1020828770002Medicaid
PA021206QCYMedicare PIN