Individual
CHARLENE M. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
400 N 17TH ST, ALLENTOWN, PA 18104-5052
(610) 402-9099
(610) 402-9029
Mailing address
24 S 18TH STREET, ALLENTOWN, PA 18104-5622
(610) 628-8372
(610) 628-8648
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN266339L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
040491
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063046
FIRST PRIORITY
PA
05
—
0070312970003
—
PA
01
—
01484202
CAPITAL ADVANTAGE
PA
01
—
0718259000
INDEP. BLUE CROSS
PA
01
—
11766001
CAQH
PA
01
—
1585085
GATEWAY
PA
01
—
82832
GEISINGER
PA
01
—
9699193
AETNA
PA
Enumeration date
10/05/2005
Last updated
11/24/2015
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