Healthcare Provider Details

I. General information

NPI: 1437400215
Provider Name (Legal Business Name): JENNIFER MARIE TSANGARIS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MARIE POPE CRNA

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

V. Phone/Fax

Practice location:
  • Phone: 412-858-4485
  • Fax: 412-858-3190
Mailing address:
  • Phone: 412-858-4485
  • Fax: 412-858-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN595542
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: