Healthcare Provider Details

I. General information

NPI: 1073906319
Provider Name (Legal Business Name): VERONICA K EKEROTH F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

6860 STEPHANIE CT
DELMONT PA
15626-1592
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5055
  • Fax:
Mailing address:
  • Phone: 724-733-3964
  • Fax: 412-692-6675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTP001635-B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: