Provider Demographics
NPI:1770176679
Name:STERBUTZEL, JENNIFER HAKY (CRNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HAKY
Last Name:STERBUTZEL
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 1:3085 OLD MCCLELLANDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MC CLELLANDTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15458-1187
Mailing Address - Country:US
Mailing Address - Phone:724-322-4540
Mailing Address - Fax:
Practice Address - Street 1:2614A MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1405
Practice Address - Country:US
Practice Address - Phone:724-603-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022782363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care