Provider Demographics
NPI:1891198313
Name:HAENER, ALLISON E (CRNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:HAENER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:TOST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:104 E 2ND ST FL 5
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1532
Mailing Address - Country:US
Mailing Address - Phone:814-877-3900
Mailing Address - Fax:814-877-3950
Practice Address - Street 1:104 E 2ND ST FL 5
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1532
Practice Address - Country:US
Practice Address - Phone:814-877-3900
Practice Address - Fax:814-877-3950
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014181363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner