Individual
RACHAEL ANN FORNWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
239 COLONNADE BLVD FL 2, STATE COLLEGE, PA 16803-2668
(582) 220-2215
(582) 220-2216
Mailing address
239 COLONNADE BLVD FL 2, STATE COLLEGE, PA 16803-2668
(582) 220-2215
(582) 220-2216
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R201859
MD
363L00000X
Nurse Practitioner
Primary
SPO29497
PA
Other
Enumeration date
03/17/2015
Last updated
05/11/2026
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