Provider Demographics
NPI:1063509669
Name:STRAZDUS, ANN M (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:STRAZDUS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 HIGHWAY 315
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6952
Mailing Address - Country:US
Mailing Address - Phone:570-823-8896
Mailing Address - Fax:570-823-1291
Practice Address - Street 1:1130 HIGHWAY 315
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6952
Practice Address - Country:US
Practice Address - Phone:570-823-8896
Practice Address - Fax:570-823-1291
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006994C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP38875Medicare UPIN