Healthcare Provider Details

I. General information

NPI: 1649480187
Provider Name (Legal Business Name): TERESA SOKOLOWSKI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 LEBANON CHURCH RD
WEST MIFFLIN PA
15122-2456
US

IV. Provider business mailing address

421 SCENERIDGE ROAD
MCKEESPORT PA
15133
US

V. Phone/Fax

Practice location:
  • Phone: 412-655-8515
  • Fax:
Mailing address:
  • Phone: 412-673-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP003266B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: