Provider Demographics
NPI:1376565879
Name:CHMIELEWSKI, JOANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:URSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN CRNP
Mailing Address - Street 1:4416 PENN AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224
Mailing Address - Country:US
Mailing Address - Phone:412-681-2211
Mailing Address - Fax:412-687-0728
Practice Address - Street 1:128 ROBINHOOD DRIVE
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066
Practice Address - Country:US
Practice Address - Phone:724-742-3253
Practice Address - Fax:724-742-3233
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005662L363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA316635OtherUPMC
PA673053OtherBLUE CROSS BLUE SHIELD PA
PA631569OtherHIGHMARK
S83503Medicare UPIN
PA028422Medicare PIN
PA631569OtherHIGHMARK