Basic Information
| Provider Information | |||||||||
| NPI: | 1861858169 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OCHS | ||||||||
| FirstName: | PAULA | ||||||||
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| Credential: | CRNP FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 ICE LAKE DR | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN TOP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187079654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702414715 | ||||||||
| FaxNumber: | 5703417405 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | HAZLETON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182016835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705524450 | ||||||||
| FaxNumber: | 5705524455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | SP015152 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LF0000X | SP015152 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 103155780-0001 | 05 | PA | MEDICAID |