Healthcare Provider Details

I. General information

NPI: 1730858887
Provider Name (Legal Business Name): JAMIE A HOZELLA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE A WALZER PA-C

II. Dates (important events)

Enumeration Date: 09/11/2021
Last Update Date: 10/19/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2566 HAYMAKER RD STE 201
MONROEVILLE PA
15146-3555
US

IV. Provider business mailing address

2566 HAYMAKER RD STE 201
MONROEVILLE PA
15146-3555
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3457
  • Fax: 412-359-6699
Mailing address:
  • Phone: 412-359-3457
  • Fax: 412-359-6699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA062901
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMA062901
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: