Healthcare Provider Details

I. General information

NPI: 1740628643
Provider Name (Legal Business Name): TERRI LYNN RAPP CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 S CLEARVIEW RD
GLENSHAW PA
15116-2101
US

IV. Provider business mailing address

1931 S. CLEARVIEW ROAD
GLENSHAW PA
15116
US

V. Phone/Fax

Practice location:
  • Phone: 412-487-2411
  • Fax:
Mailing address:
  • Phone: 412-487-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP007174
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: