Healthcare Provider Details

I. General information

NPI: 1104152834
Provider Name (Legal Business Name): DAWN KEDDIE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2009
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 S 27TH ST STE 201
PITTSBURGH PA
15203-2378
US

IV. Provider business mailing address

701 TECHNOLOGY DR STE 150
CANONSBURG PA
15317-9531
US

V. Phone/Fax

Practice location:
  • Phone: 412-381-1949
  • Fax: 412-381-1965
Mailing address:
  • Phone: 412-531-2902
  • Fax: 412-531-2948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP010558
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: