Krista Hollis, CRNP
Individual provider Active NPI Nurse Practitioner · Forest City, PA
NPI 1992138135 · NPPES record last updated Apr 6, 2023
Key facts
- NPI
- 1992138135
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- SP013058 (PA)
- Practice address
- 100 Dundaff St
Forest City, PA 18421-1317 - Phone
- (570) 785-3194
- Fax
- (570) 785-9775
- NPI assigned
- Aug 12, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141002000692 | PA | Order and Referring Only - Nurse Practitioner | 1850511437 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP013058 | PA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP013058 | PA | Yes |
Addresses
Primary practice location
100 Dundaff St
Forest City, PA 18421-1317
Mailing address
601 Park St
Honesdale, PA 18431-1445
Phone (570) 253-8226
Other providers in Forest City, PA
- Christopher Michael Granville
- Kimberly A Gregorowicz
- Stephanie Grzymski
- Rosalind Ignacio Hartland
- Shannon Barbara Henderson
- Amanda Marie Imperiale
- Joseph S Miskovsky
- Michael Keyasko
- Elizabeth Marie Kinney
- Denise Kopa
All providers in Forest City, PA · Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.