Provider Demographics
NPI:1467432153
Name:BLASINSKY, JOAN M (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:M
Last Name:BLASINSKY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6332 OYSTER BAY CT
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-3421
Mailing Address - Country:US
Mailing Address - Phone:772-285-3960
Mailing Address - Fax:412-221-7577
Practice Address - Street 1:2969 SE LEXINGTON LAKES DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5763
Practice Address - Country:US
Practice Address - Phone:772-285-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN238035L367500000X
WV61203367500000X
FLRN3138002367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00384412OtherRAILROAD MEDICARE
OH2734072Medicaid
FL304073900Medicaid
WV3810008523Medicaid
MD976602200Medicaid
PA0019734030004Medicaid
WV3810008523Medicaid
FLG2124XMedicare PIN
WVP00384412OtherRAILROAD MEDICARE