Healthcare Provider Details

I. General information

NPI: 1518248483
Provider Name (Legal Business Name): EMILY ANN KAHLE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 E NORTH AVE SUITE 300
PITTSBURGH PA
15212-4771
US

IV. Provider business mailing address

1620 N MAIN ST
SPANISH FORK UT
84660-1008
US

V. Phone/Fax

Practice location:
  • Phone: 412-322-7202
  • Fax: 412-322-2144
Mailing address:
  • Phone: 801-822-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA055124
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: