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General NPI Number Information
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NPI Number | 1366204638
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Entity Type | Individual
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Provider Name | MIA JASINSKI CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 10210 N 92ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4509
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Country | US
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Telephone | 480-882-7750
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 DUNNING DR
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City | WEST CHESTER
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State | PA
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Zip | 19382-7584
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP029018
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 309643
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License Number State | AZ
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