Basic Information
Provider Information
NPI: 1306867858
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRYZBYLKOWSKI
FirstName: ANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MEIER
OtherFirstName: ANNE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNP
OtherLastNameType: 1
Mailing Information
Address1: 625 S DUKE ST
Address2:  
City: LANCASTER
State: PA
PostalCode: 176024509
CountryCode: US
TelephoneNumber: 7172996371
FaxNumber: 7173978881
Practice Location
Address1: 625 S DUKE ST
Address2:  
City: LANCASTER
State: PA
PostalCode: 176024509
CountryCode: US
TelephoneNumber: 7172996371
FaxNumber: 7173978881
Other Information
ProviderEnumerationDate: 07/21/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP006421BPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home