Healthcare Provider Details

I. General information

NPI: 1699502104
Provider Name (Legal Business Name): KRISTA MICHALSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 QUAKER VILLAGE SHOPPING CTR STE 2A
LEETSDALE PA
15056-1206
US

IV. Provider business mailing address

1 PEARTREE WAY
BEAVER PA
15009-1954
US

V. Phone/Fax

Practice location:
  • Phone: 724-773-4704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: