Healthcare Provider Details

I. General information

NPI: 1972146066
Provider Name (Legal Business Name): AMANDA MICHELLE YRIBERRI CRNA, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

129 WESTBROOKE LN
CORAOPOLIS PA
15108-9138
US

V. Phone/Fax

Practice location:
  • Phone: 412-977-4734
  • Fax:
Mailing address:
  • Phone: 412-977-4734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number130157
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: