Basic Information
| Provider Information | |||||||||
| NPI: | 1184138455 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VALLANO | ||||||||
| FirstName: | JANELLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DEARFIELD | ||||||||
| OtherFirstName: | JANELLE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 97887 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152270287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126554362 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3540 WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | MC MURRAY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153172957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249410707 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2017 | ||||||||
| LastUpdateDate: | 11/25/2017 | ||||||||
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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 | 363LF0000X | SP018056 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | SP018056 | 01 | PA | STATE LICENSE | OTHER |