Healthcare Provider Details

I. General information

NPI: 1740327113
Provider Name (Legal Business Name): JANET A CIPKALA-GAFFIN MN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 PERRY HWY SUITE 309
WEXFORD PA
15090-8379
US

IV. Provider business mailing address

2523 MATTERHORN DR
WEXFORD PA
15090-7963
US

V. Phone/Fax

Practice location:
  • Phone: 724-940-2363
  • Fax: 724-935-0968
Mailing address:
  • Phone: 724-940-2363
  • Fax: 724-935-0968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberRN318606L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: