Healthcare Provider Details

I. General information

NPI: 1962927608
Provider Name (Legal Business Name): ELIZABETH ANN CAREY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 08/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 5TH AVE
MCKEESPORT PA
15132-2422
US

IV. Provider business mailing address

616 GREENFIELD AVE
PITTSBURGH PA
15207-1147
US

V. Phone/Fax

Practice location:
  • Phone: 412-664-2000
  • Fax:
Mailing address:
  • Phone: 484-467-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP017743
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: