Provider Demographics
NPI:1679536965
Name:JEDINAK, MAUREEN P (CRNA)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:P
Last Name:JEDINAK
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 1:166 EDGEMEADE DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1078
Mailing Address - Country:US
Mailing Address - Phone:412-798-9552
Mailing Address - Fax:
Practice Address - Street 1:495 WATERFRONT DR E
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1140
Practice Address - Country:US
Practice Address - Phone:412-325-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN211633L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
S59216Medicare UPIN