Healthcare Provider Details

I. General information

NPI: 1134054448
Provider Name (Legal Business Name): MILLCREEK COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 W 38TH ST UPPR LEVEL
ERIE PA
16508-2004
US

IV. Provider business mailing address

5515 PEACH ST
ERIE PA
16509-2603
US

V. Phone/Fax

Practice location:
  • Phone: 814-866-6835
  • Fax: 814-866-6837
Mailing address:
  • Phone: 814-864-4031
  • Fax: 814-868-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JEAN NEJMAN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 814-868-2507