Individual
CONCETTA M VIVIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
5100 W TILGHMAN ST STE 315, ALLENTOWN, PA 18104-9166
(610) 395-4044
(610) 395-5693
Mailing address
PO BOX 783497, PHILADELPHIA, PA 19178-3497
(610) 395-4044
(610) 395-5693
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN239821L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN239821L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00237876
RAILROAD MC PROV#
PA
Enumeration date
03/28/2006
Last updated
02/11/2020
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