Healthcare Provider Details

I. General information

NPI: 1013133032
Provider Name (Legal Business Name): SHARON K STOBERT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HILL AVE
CHESWICK PA
15024-1400
US

IV. Provider business mailing address

105 HILL AVE
CHESWICK PA
15024-1400
US

V. Phone/Fax

Practice location:
  • Phone: 724-274-8812
  • Fax: 724-274-5660
Mailing address:
  • Phone: 724-274-8812
  • Fax: 724-274-5660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN245266L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberUP005860W
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: