Provider Demographics
NPI:1710112073
Name:SZYMANSKI, JULIE ANN (CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:SZYMANSKI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 CLARION RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15845-1656
Mailing Address - Country:US
Mailing Address - Phone:814-389-4411
Mailing Address - Fax:814-389-4142
Practice Address - Street 1:81 CLARION RD
Practice Address - Street 2:
Practice Address - City:JOHNSONBURG
Practice Address - State:PA
Practice Address - Zip Code:15845-1656
Practice Address - Country:US
Practice Address - Phone:814-389-4411
Practice Address - Fax:814-389-4142
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010195367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102321036Medicaid
PA155479YNJYMedicare PIN