Healthcare Provider Details

I. General information

NPI: 1851354757
Provider Name (Legal Business Name): MEGAN CATHARINE SPIVAK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN CATHARINE MILLER CRNA

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD DEPT OF
MONROEVILLE PA
15146-3513
US

IV. Provider business mailing address

2570 HAYMAKER RD DEPT OF
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 NumberRN-510577-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: