Provider Demographics
NPI:1467729145
Name:MODAFFARI, JAMIE LEE (MSN, CRNP)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:LEE
Last Name:MODAFFARI
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 DUNCAN AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5803
Mailing Address - Country:US
Mailing Address - Phone:412-847-1290
Mailing Address - Fax:
Practice Address - Street 1:8950 DUNCAN AVE FL 4
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5803
Practice Address - Country:US
Practice Address - Phone:412-847-1290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily