Provider Demographics
NPI:1689608911
Name:VANARSDALE, JANNIS JEAN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JANNIS
Middle Name:JEAN
Last Name:VANARSDALE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JANNIS
Other - Middle Name:ARMSTRONG
Other - Last Name:VANARSDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2000
Mailing Address - Fax:717-812-2010
Practice Address - Street 1:1575 BANNISTER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-4946
Practice Address - Country:US
Practice Address - Phone:717-812-2000
Practice Address - Fax:717-851-2010
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP0018743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA105162OtherJOHNS HOPKINS
PA1547547OtherGATEWAY-WMG
PA03006301OtherCAPITAL BLUE CROSSYFM
PA50051736OtherCAPITAL BC-WMG (PEDS)
PA1916432OtherHIGHMARK BLUE SHIELD
MD618406OtherCAREFIRST MD BCBS
PA50051732OtherCAPITAL BC-WMG (IM)
PA105162OtherJOHNS HOPKINS
MD618406OtherCAREFIRST MD BCBS
PA50051736OtherCAPITAL BC-WMG (PEDS)
PA50051732OtherCAPITAL BC-WMG (IM)
PA201496EZ3Medicare PIN