Provider Demographics
NPI:1053413922
Name:MARJANOVIC, ALISON E (CRNA)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:E
Last Name:MARJANOVIC
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:E
Other - Last Name:MARINAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:555 NORTH DUKE STREET
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:717-544-7157
Practice Address - Street 1:555 NORTH DUKE STREET
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:717-544-7157
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN519254L163W00000X, 367500000X
PA054765367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001469278OtherHIGHMARK BLUE SHIELD
PA001469278OtherHIGHMARK BLUE SHIELD