Provider Demographics
NPI:1174237184
Name:MICHNIAK, LYUDMYLA (CRNP)
Entity type:Individual
Prefix:
First Name:LYUDMYLA
Middle Name:
Last Name:MICHNIAK
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 1:210 EVELYN DR
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3217
Mailing Address - Country:US
Mailing Address - Phone:610-937-1715
Mailing Address - Fax:
Practice Address - Street 1:210 EVELYN DR
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3217
Practice Address - Country:US
Practice Address - Phone:610-937-1715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASTUDENT363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health