Provider Demographics
NPI:1982893848
Name:KREBS, KRISTIN ELIZABETH (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:KREBS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ELIZABETH
Other - Last Name:DICOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:409 SOUTH SECOND STREET
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:361 ALEXANDER SPRING RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-6940
Practice Address - Country:US
Practice Address - Phone:717-249-1212
Practice Address - Fax:717-519-0684
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN546217367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102101524Medicaid
PAP00860323Medicare PIN
PA1581598OtherGATEWAY-GH
PA279948OtherUNISON-GH
PA102101524Medicaid
PA119028FEVMedicare PIN
PA2015168OtherHIGHMARK BLUE SHIELD