Provider Demographics
NPI:1295154441
Name:KOMEDJA, HANNAH (APRN)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:KOMEDJA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ELIE-HANNAH
Other - Middle Name:
Other - Last Name:WEICK-DIDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2975
Mailing Address - Country:US
Mailing Address - Phone:614-670-3333
Mailing Address - Fax:
Practice Address - Street 1:1034 GROVE ST STE G1
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2945
Practice Address - Country:US
Practice Address - Phone:814-807-1202
Practice Address - Fax:814-807-1210
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026464363L00000X, 363L00000X
PARN756952163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse