Healthcare Provider Details

I. General information

NPI: 1912859497
Provider Name (Legal Business Name): ANNETTE MARIE MEDERO-RODRIGUEZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3824 NORTHERN PIKE STE 200
MONROEVILLE PA
15146-2173
US

IV. Provider business mailing address

3341 MAYER DR
MURRYSVILLE PA
15668-1619
US

V. Phone/Fax

Practice location:
  • Phone: 412-380-2800
  • Fax:
Mailing address:
  • Phone: 787-225-1014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP035539
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN753562
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: