Provider Demographics
NPI:1285463141
Name:CZERWINSKI, MYKELA FAWN (CD(DONA))
Entity type:Individual
Prefix:
First Name:MYKELA
Middle Name:FAWN
Last Name:CZERWINSKI
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:MYKELA
Other - Middle Name:FAWN
Other - Last Name:CZERWINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3855 ROXANNA DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16510-3959
Mailing Address - Country:US
Mailing Address - Phone:716-223-0608
Mailing Address - Fax:
Practice Address - Street 1:3855 ROXANNA DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-3959
Practice Address - Country:US
Practice Address - Phone:716-223-0608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA14722374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula