Provider Demographics
NPI:1184703100
Name:ROADARMEL, SANDRA J (CRNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:ROADARMEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 YORK RD
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3211
Mailing Address - Country:US
Mailing Address - Phone:215-884-7620
Mailing Address - Fax:
Practice Address - Street 1:314 YORK RD
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3211
Practice Address - Country:US
Practice Address - Phone:215-884-7620
Practice Address - Fax:215-884-7896
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000849C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS61043Medicare UPIN
PACD4829Medicare PIN
PA597586Medicare PIN
PA013963JTQMedicare PIN