Healthcare Provider Details
I. General information
NPI: 1750772646
Provider Name (Legal Business Name): LANA MARIE HULBERT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/12/2015
Last Update Date: 02/14/2021
Certification Date: 02/14/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3005A BANKSVILLE RD
PITTSBURGH PA
15216
US
IV. Provider business mailing address
2891 BANKSVILLE RD
PITTSBURGH PA
15216-2815
US
V. Phone/Fax
- Phone: 412-942-0702
- Fax: 412-942-0733
- Phone: 412-942-0702
- Fax: 412-942-0733
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP014789 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: