=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326121765
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELE DENIAL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2006
-----------------------------------------------------
Last Update Date | 10/22/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1024 W VIEW PARK DR
-----------------------------------------------------
City | WEST VIEW
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15229-1771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-223-1029
-----------------------------------------------------
Fax | 412-223-1013
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1024 W VIEW PARK DR
-----------------------------------------------------
City | WEST VIEW
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15229-1771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-223-1029
-----------------------------------------------------
Fax | 441-223-1013
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP003769B
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------