Healthcare Provider Details

I. General information

NPI: 1922403229
Provider Name (Legal Business Name): HEATHER CARGO CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ALLEGHENY AVE STE 101
OAKMONT PA
15139-2072
US

IV. Provider business mailing address

333 ALLEGHENY AVE STE 101
OAKMONT PA
15139-2072
US

V. Phone/Fax

Practice location:
  • Phone: 412-423-1048
  • Fax: 412-828-7580
Mailing address:
  • Phone: 412-423-1048
  • Fax: 412-828-7580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP014275
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: