Healthcare Provider Details

I. General information

NPI: 1437123668
Provider Name (Legal Business Name): SANDRA JANE LETTERLE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 TERRACE STREET A1305 SCAIFE HALL
PITTSBURGH PA
15261-0001
US

IV. Provider business mailing address

3550 TERRACE STREET A1305 SCAIFE HALL
PITTSBURGH PA
15261-0001
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2167
  • Fax:
Mailing address:
  • Phone: 412-623-2167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN271274L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: