Healthcare Provider Details

I. General information

NPI: 1174802102
Provider Name (Legal Business Name): SANDRA V ALWAY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9335 MCKNIGHT RD
PITTSBURGH PA
15237-5903
US

IV. Provider business mailing address

9335 MCKNIGHT RD
PITTSBURGH PA
15237-5903
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-5588
  • Fax: 412-605-6544
Mailing address:
  • Phone: 412-578-5588
  • Fax: 412-605-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberVP001848G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: