Provider Demographics
NPI:1144700790
Name:OCKER, ANITA MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:OCKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:PIFER
Other - Last Name:OCKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:601 MEMORY LANE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:112 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1720
Practice Address - Country:US
Practice Address - Phone:717-262-4546
Practice Address - Fax:717-263-1146
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019247363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14326582OtherCAQH
PA103568637Medicaid