Michaela May Omatick, CRNP

Individual provider Active NPI Adult Health Nurse Practitioner · Dover, PA

NPI 1174860985 · NPPES record last updated Oct 7, 2015

Key facts

NPI
1174860985
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
SP012698 (PA)
Practice address
4128 Strawbridge CT
Dover, PA 17315-4264
Phone
(717) 858-7414
NPI assigned
Jan 14, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choices Healthcare Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP012698 PA Yes

Addresses

Primary practice location

4128 Strawbridge CT
Dover, PA 17315-4264

Mailing address

4128 Strawbridge CT
Dover, PA 17315-4264
Phone (717) 858-7414

Other identifiers

IdentifierTypeStateIssuer
1616256OtherPAGATEWAY MEDICARE ASSURED

Other names

  • Michaela May Allison Former name

Other providers in Dover, PA

All providers in Dover, PA · Adult Health Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.