Healthcare Provider Details

I. General information

NPI: 1598639510
Provider Name (Legal Business Name): KATRINA ELIZABETH KUDLA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3704
US

IV. Provider business mailing address

600 ROSEWOOD CT # 600B
PITTSBURGH PA
15236-4714
US

V. Phone/Fax

Practice location:
  • Phone: 412-466-1125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP033824
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: