Healthcare Provider Details

I. General information

NPI: 1538290739
Provider Name (Legal Business Name): JUDY KAUFMANN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 WASHINGTON RD SUITE TL#4
PITTSBURGH PA
15228-1901
US

IV. Provider business mailing address

615 WASHINGTON RD SUITE TL#4
PITTSBURGH PA
15228-1901
US

V. Phone/Fax

Practice location:
  • Phone: 412-343-1770
  • Fax: 412-343-0596
Mailing address:
  • Phone: 412-343-1770
  • Fax: 412-343-0596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP001532B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: