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General NPI Number Information
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NPI Number | 1356341374
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Entity Type | Individual
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Provider Name | DONNA B. GISLESON MSN, CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 1900 WATERDAM PLAZA DR BLDG 32ND
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City | CANONSBURG
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State | PA
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Zip | 15317-5442
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Country | US
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Telephone | 724-941-7490
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Fax | 724-941-5231
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Provider Business Mailing Address
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Address Line | 1900 WATERDAM PLAZA DR BLDG 32ND
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City | CANONSBURG
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State | PA
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Zip | 15317-5442
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Country | US
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Telephone | 724-941-7490
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Fax | 724-941-5231
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | VP004870B
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License Number State | PA
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