Provider Demographics
NPI:1851535462
Name:YANNACCONE, ROZALYN L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ROZALYN
Middle Name:L
Last Name:YANNACCONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 MOORE AVE
Mailing Address - Street 2:BUCKNELL UNIVERSITY, ZIEGLER HEALTH
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-2010
Mailing Address - Country:US
Mailing Address - Phone:570-577-1332
Mailing Address - Fax:570-577-3570
Practice Address - Street 1:701 MOORE AVE
Practice Address - Street 2:ZIEGLER HEALTH CENTER
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-2010
Practice Address - Country:US
Practice Address - Phone:570-577-1401
Practice Address - Fax:570-577-3570
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000171F363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner