Healthcare Provider Details

I. General information

NPI: 1134102486
Provider Name (Legal Business Name): PATRICIA A HEMSHRODT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MORROW WAY 204 CAMPUS DR.
SLIPPERY ROCK PA
16057-1314
US

IV. Provider business mailing address

114 FRANKLIN OAKS DR
BUTLER PA
16001-0202
US

V. Phone/Fax

Practice location:
  • Phone: 724-738-2052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTP006407B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: