Healthcare Provider Details

I. General information

NPI: 1871567040
Provider Name (Legal Business Name): NANCY J DE LA FUENTE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY GAGORIK CRNP

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1391 WASHINGTON BLVD
PITTSBURGH PA
15206-1801
US

IV. Provider business mailing address

12 SUBURBAN AVE
CARNEGIE PA
15106-1440
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-9222
  • Fax: 412-661-9395
Mailing address:
  • Phone: 412-427-6975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN216279L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: