Individual
COLEEN PREVOZNIK ALVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-8896
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-8896
(610) 402-9029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN578028
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
89658
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027798420001
—
PA
01
—
12320856
CAQH
PA
01
—
1437428547
GEISINGER
PA
01
—
1605007
GATEWAY
PA
01
—
2678586
FIRST PRIORITY
PA
01
—
3871473000
IND. BLUE CROSS
PA
01
—
50105449
CAPITAL ADVANTAGE
PA
01
—
9028831
AETNA
PA
Enumeration date
12/19/2011
Last updated
09/23/2014
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