Healthcare Provider Details

I. General information

NPI: 1356536924
Provider Name (Legal Business Name): DEBORA ERB HOLETS-ROSSI RN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 06/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 SHEARER ST
GREENSBURG PA
15601-2746
US

IV. Provider business mailing address

920 WINTER ST 3W-16
WALTHAM MA
02451-1521
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-8061
  • Fax: 724-832-9311
Mailing address:
  • Phone: 781-699-2924
  • Fax: 781-699-4322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN260235L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP009492
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: