Provider Demographics
NPI:1982853800
Name:JAMIESON, SHENOA ROSE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SHENOA
Middle Name:ROSE
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SHENOA
Other - Middle Name:ROSE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4401 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1334
Mailing Address - Country:US
Mailing Address - Phone:412-692-6257
Mailing Address - Fax:412-692-8399
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-6257
Practice Address - Fax:412-692-8399
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009197363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics