Healthcare Provider Details

I. General information

NPI: 1821631771
Provider Name (Legal Business Name): KRISTEN RAHALL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 ALLEQUIPPA STREET
PITTSBURGH PA
15213
US

IV. Provider business mailing address

UNIVERSITY DRIVE
PITTSBURGH PA
15240
US

V. Phone/Fax

Practice location:
  • Phone: 412-822-2222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN649105
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberSP021016
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: