Healthcare Provider Details

I. General information

NPI: 1144038738
Provider Name (Legal Business Name): ERIN KELLY BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VB360A 3500 VICTORIA STREET
PITTSBURGH PA
15261-0001
US

IV. Provider business mailing address

VB360A 3500 VICTORIA STREET
PITTSBURGH PA
15261-1429
US

V. Phone/Fax

Practice location:
  • Phone: 888-747-0794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN746635
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: