Healthcare Provider Details

I. General information

NPI: 1194588855
Provider Name (Legal Business Name): TESSA MANOLIS MEENAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

2580 HAYMAKER RD
MONROEVILLE PA
15146-3518
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-5323
  • Fax: 412-578-4981
Mailing address:
  • Phone: 412-858-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number147924
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: