Healthcare Provider Details

I. General information

NPI: 1992374219
Provider Name (Legal Business Name): JESSICA SIVETZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 WATERDAM PLAZA DR STE 220
MC MURRAY PA
15317-5415
US

IV. Provider business mailing address

2 ALLEGHENY CTR STE 530
PITTSBURGH PA
15212-5404
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-2747
  • Fax:
Mailing address:
  • Phone: 412-330-5851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP023893
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP023893
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: