Provider Demographics
NPI:1861859118
Name:WASACZ, SANDY JO (DNP,CRNP,AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:JO
Last Name:WASACZ
Suffix:
Gender:F
Credentials:DNP,CRNP,AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3518
Mailing Address - Country:US
Mailing Address - Phone:330-559-3826
Mailing Address - Fax:
Practice Address - Street 1:2 HOT METAL ST
Practice Address - Street 2:QUANTUM BLDG. 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2348
Practice Address - Country:US
Practice Address - Phone:412-432-7400
Practice Address - Fax:412-432-7480
Is Sole Proprietor?:No
Enumeration Date:2016-01-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18452-NP363LA2100X
PASP015825363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care