Individual
STEPHANIE GRENCAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
390 PIERCE ST, KINGSTON, PA 18704-5532
(570) 288-3535
Mailing address
390 PIERCE ST, KINGSTON, PA 18704-5532
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP011229
PA
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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