Provider Demographics
NPI:1750331633
Name:JEROSKI, ERNESTINE (CRNA)
Entity Type:Individual
Prefix:
First Name:ERNESTINE
Middle Name:
Last Name:JEROSKI
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 1:419 RODI ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4566
Mailing Address - Country:US
Mailing Address - Phone:412-731-8000
Mailing Address - Fax:412-731-8399
Practice Address - Street 1:419 RODI ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-4566
Practice Address - Country:US
Practice Address - Phone:412-731-8000
Practice Address - Fax:412-731-8399
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN136909L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered