Healthcare Provider Details

I. General information

NPI: 1730357575
Provider Name (Legal Business Name): TERRY L MARRAWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRY L ONDECHECK

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

PO BOX 951915
CLEVELAND OH
44193-0021
US

V. Phone/Fax

Practice location:
  • Phone: 800-394-4445
  • Fax: 706-650-1034
Mailing address:
  • Phone: 800-394-4445
  • Fax: 706-650-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN288948L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: