Provider Demographics
NPI:1104574425
Name:UZELAC, JESSICA JEAN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JEAN
Last Name:UZELAC
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1322 EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3307
Mailing Address - Country:US
Mailing Address - Phone:814-266-8840
Mailing Address - Fax:814-266-2176
Practice Address - Street 1:1322 EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3307
Practice Address - Country:US
Practice Address - Phone:814-266-8840
Practice Address - Fax:814-266-2176
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily