Healthcare Provider Details

I. General information

NPI: 1255618161
Provider Name (Legal Business Name): DEBORAH CONWAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 11/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 OHARA ST DEC - 1ST FLOOR
PITTSBURGH PA
15213-2597
US

IV. Provider business mailing address

3811 OHARA ST DEC - 1ST FLOOR
PITTSBURGH PA
15213-2597
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-9380
  • Fax:
Mailing address:
  • Phone: 412-647-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN614424
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN614424
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: