Most Relevant Information
Provider Data
| NPI Number: | 1003290404 |
| Provider Name: | JAMIE L PARK CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | SP015055 |
Most Important Dates
| Enumeration Date: | 07/15/2015 |
| Last Updated: | 07/15/2015 |
Provider Practice Location
90 SHENANGO ST
GREENVILLE
PA
161252060
Practice Location Phone/Fax
| Phone: | 7245884240 |
| Fax: |
Provider Mailing Location
90 SHENANGO ST
GREENVILLE
PA
161252060
Provider Mailing Phone/Fax
| Phone: | 7245884240 |
| Fax: |