Provider Demographics
NPI:1982653960
Name:CHMURA, JOANNE Q (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:Q
Last Name:CHMURA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2105
Mailing Address - Country:US
Mailing Address - Phone:716-832-4859
Mailing Address - Fax:
Practice Address - Street 1:1000 YOUNGS RD STE 101
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2644
Practice Address - Country:US
Practice Address - Phone:716-204-4532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily