Jeremy Athelstone

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Slippery Rock, PA

NPI 1861116675 · NPPES record last updated Sep 27, 2022

Key facts

NPI
1861116675
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
101 Field House Rd
Slippery Rock, PA 16057
Phone
(800) 778-9111
NPI assigned
Sep 27, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PA Yes

Addresses

Primary practice location

101 Field House Rd
Slippery Rock, PA 16057

Mailing address

1608 Treasure LK
Du Bois, PA 15801-9043

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL file Health Information Exchange (HIE)

Other providers in Slippery Rock, PA

All providers in Slippery Rock, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.