Healthcare Provider Details

I. General information

NPI: 1215664230
Provider Name (Legal Business Name): JUSTINA ANGELINE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CLIFFMINE RD STE 500
PITTSBURGH PA
15275-1053
US

IV. Provider business mailing address

2000 CLIFFMINE RD STE 300
PITTSBURGH PA
15275-1008
US

V. Phone/Fax

Practice location:
  • Phone: 866-269-8038
  • Fax:
Mailing address:
  • Phone: 878-269-8038
  • Fax: 878-332-4479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP025993
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0032715
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: