Provider Demographics
NPI:1538893003
Name:WOZNICKI, LOGAN N (RN)
Entity type:Individual
Prefix:MR
First Name:LOGAN
Middle Name:N
Last Name:WOZNICKI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 E LAKEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-2025
Mailing Address - Country:US
Mailing Address - Phone:144-313-8968
Mailing Address - Fax:
Practice Address - Street 1:307 E LAKEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-2025
Practice Address - Country:US
Practice Address - Phone:814-431-3896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN720703163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse