Individual
HEATHER MICHELLE KOWALISHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
179 INDEPENDENCE RD, EAST STROUDSBURG, PA 18301
(570) 421-3900
(570) 424-1549
Mailing address
106 SHAWNEE SQUARE SUITE 101, SHAWNEE ON DELAWARE, PA 18356
(570) 421-3900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP018125
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
637151PZP
MEDICARE
PA
Enumeration date
11/16/2017
Last updated
08/01/2018
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