Provider Demographics
NPI:1912473828
Name:ZAZWORSKY, JACLYN MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:MARIE
Last Name:ZAZWORSKY
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 1:1900 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-6026
Mailing Address - Country:US
Mailing Address - Phone:814-205-1250
Mailing Address - Fax:814-205-1251
Practice Address - Street 1:1900 RIVER RD
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-6026
Practice Address - Country:US
Practice Address - Phone:814-205-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019342363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care