Individual provider · Type 1 NPI
Jon Alvin Modesto, RN
Psychiatric/Mental Health Nurse Practitioner · Danville, PA
NPI number
1295235984
Active
Practice location
746 Avenue D
Danville, PA 17821-7635
Fax (570) 961-3364
Other practice locations
- 308 E 2nd St, Bloomsburg, PA 17815-1869 · (570) 961-3361
- 1083 Bloom Rd, Danville, PA 17821-6789 · (570) 961-3361
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN-85497 (NM) |
| Emergency Registered Nurse | 163WE0003X | RN712916 (PA) |
| Registered Nurse | 163W00000X | RN2320628 (MA) |
| Registered Nurse | 163W00000X | 884244 (TX) |
| Registered Nurse | 163W00000X | RN205182 (AZ) |
| Registered Nurse | 163W00000X | 95118046 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | SP036426 (PA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1295235984
Jon Alvin Modesto, RN's National Provider Identifier is 1295235984, issued on Feb 19, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Danville, PA. The record was last updated on Oct 19, 2026.