Healthcare Provider Details

I. General information

NPI: 1851569669
Provider Name (Legal Business Name): ALYSSA ANN HINES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 FRIENDSHIP AVE
PITTSBURGH PA
15224-1722
US

IV. Provider business mailing address

4 ALLEGHENY CTR FL 7
PITTSBURGH PA
15212-5255
US

V. Phone/Fax

Practice location:
  • Phone: 800-394-4445
  • Fax: 706-650-1034
Mailing address:
  • Phone: 412-330-5861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN517649L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: