Basic Information
Provider Information
NPI: 1083365753
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VLAHOS
FirstName: JENNIFER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 565 COAL VALLEY RD
Address2:  
City: JEFFERSON HILLS
State: PA
PostalCode: 150253703
CountryCode: US
TelephoneNumber: 4124695000
FaxNumber:  
Practice Location
Address1: 565 COAL VALLEY RD
Address2:  
City: JEFFERSON HILLS
State: PA
PostalCode: 150253703
CountryCode: US
TelephoneNumber: 4124695000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/14/2022
LastUpdateDate: 08/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X130156PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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