Healthcare Provider Details

I. General information

NPI: 1932347358
Provider Name (Legal Business Name): MARY ANN KNECHTEL RN, CRNP-BC, ANP,GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 SWALLOW HILL RD
PITTSBURGH PA
15220-1656
US

IV. Provider business mailing address

332 DUTCHTOWN RD
BUTLER PA
16002-0620
US

V. Phone/Fax

Practice location:
  • Phone: 412-279-4522
  • Fax:
Mailing address:
  • Phone: 724-282-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-284406-LPA
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-525897-LNY
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberANP-SP008134
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberGNP-SP007994
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: