Healthcare Provider Details

I. General information

NPI: 1306482815
Provider Name (Legal Business Name): BIENVENU NKUNZINGOMA CRNA,DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

118 TARTAN RD
GIBSONIA PA
15044-9416
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-6700
  • Fax:
Mailing address:
  • Phone: 412-491-7968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN617763
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7737
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: