Healthcare Provider Details

I. General information

NPI: 1114075827
Provider Name (Legal Business Name): CINDY S INVERSO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 VALLEYBROOK RD SUITE 300
MC MURRAY PA
15317-3367
US

IV. Provider business mailing address

455 VALLEYBROOK RD SUITE 300
MC MURRAY PA
15317-3367
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-8045
  • Fax:
Mailing address:
  • Phone: 724-941-8045
  • Fax: 724-941-1458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP007082
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierSP007082
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerSTATE LICENCE NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: