Provider Demographics
NPI:1508221045
Name:NUSSBAUM, JAMIE LYNN (FNP-C, CRNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:NUSSBAUM
Suffix:
Gender:F
Credentials:FNP-C, CRNP
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:875 GREENTREE ROAD
Mailing Address - Street 2:ONE PARKWAY CENTER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220
Mailing Address - Country:US
Mailing Address - Phone:412-388-8042
Mailing Address - Fax:412-325-0801
Practice Address - Street 1:875 GREENTREE RD
Practice Address - Street 2:ONE PARKWAY CENTER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3508
Practice Address - Country:US
Practice Address - Phone:412-388-8042
Practice Address - Fax:412-325-0801
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2020-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PARN675276163W00000X
PASP015921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse