Provider Demographics
NPI: | 1538135306 |
---|---|
Name: | VEON, JUDITH T (APRN, BC) |
Entity Type: | Individual |
Prefix: | |
First Name: | JUDITH |
Middle Name: | T |
Last Name: | VEON |
Suffix: | |
Gender: | F |
Credentials: | APRN, BC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 699 E STATE ST |
Mailing Address - Street 2: | |
Mailing Address - City: | SHARON |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 16146-2057 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 724-983-3820 |
Mailing Address - Fax: | 724-983-3941 |
Practice Address - Street 1: | 551 GREENVILLE RD |
Practice Address - Street 2: | |
Practice Address - City: | MERCER |
Practice Address - State: | PA |
Practice Address - Zip Code: | 16137-5019 |
Practice Address - Country: | US |
Practice Address - Phone: | 724-662-3831 |
Practice Address - Fax: | 724-662-3836 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-02-23 |
Last Update Date: | 2009-03-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | RN134545L | 364SP0807X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 364SP0807X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Adolescent |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
137998 | Other | TRICARE | |
2025017 | Other | CIGNA | |
VE829847 | Other | HIGHMARK | |
229525000 | Other | MAGELLAN | |
229525000 | Other | MAGELLAN |