Basic Information
| Provider Information | |||||||||
| NPI: | 1538135306 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VEON | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | APRN, BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 699 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161462057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249833820 | ||||||||
| FaxNumber: | 7249833941 | ||||||||
| Practice Location | |||||||||
| Address1: | 551 GREENVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MERCER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161375019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246623831 | ||||||||
| FaxNumber: | 7246623836 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 03/23/2009 | ||||||||
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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 | 364SP0807X | RN134545L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Child & Adolescent |
ID Information
| ID | Type | State | Issuer | Description | 137998 | 01 | TRICARE | OTHER | 2025017 | 01 | CIGNA | OTHER | VE829847 | 01 | HIGHMARK | OTHER | 229525000 | 01 | MAGELLAN | OTHER |