Basic Information
| Provider Information | |||||||||
| NPI: | 1083910376 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUSONE | ||||||||
| FirstName: | JAIME | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 STATE ST | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165500002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148774922 | ||||||||
| FaxNumber: | 8148773622 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 STATE ST | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165500002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148774922 | ||||||||
| FaxNumber: | 8148773622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2011 | ||||||||
| LastUpdateDate: | 03/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | SP011227 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.