Healthcare Provider Details

I. General information

NPI: 1184765596
Provider Name (Legal Business Name): VICTORIA A MCILNAY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 SOUTH ST SECOND FLOOR
GREENSBURG PA
15601-2775
US

IV. Provider business mailing address

520 JEFFERSON AVE SUITE 400
JEANNETTE PA
15644-2538
US

V. Phone/Fax

Practice location:
  • Phone: 724-689-1353
  • Fax: 724-689-0542
Mailing address:
  • Phone: 724-689-1353
  • Fax: 724-689-0542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberUP005955W
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: