Provider Demographics
NPI:1790466670
Name:CHI, ADAM JAMIL (CRNP)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JAMIL
Last Name:CHI
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LAVISTA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3610
Mailing Address - Country:US
Mailing Address - Phone:724-388-0556
Mailing Address - Fax:
Practice Address - Street 1:6521 ROUTE 22
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2402
Practice Address - Country:US
Practice Address - Phone:724-468-8764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily