Provider Demographics
NPI:1336270768
Name:MEINERT, JOLA (CRNP)
Entity type:Individual
Prefix:
First Name:JOLA
Middle Name:
Last Name:MEINERT
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 1:3285 BABCOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2829
Mailing Address - Country:US
Mailing Address - Phone:412-318-0075
Mailing Address - Fax:412-318-0081
Practice Address - Street 1:3285 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2829
Practice Address - Country:US
Practice Address - Phone:412-318-0075
Practice Address - Fax:412-318-0081
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000546A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAVP000546AOtherMED LICENCE NUMBER
PAS99988Medicare UPIN
PAVP000546AOtherMED LICENCE NUMBER