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General NPI Number Information
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NPI Number | 1386016855
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Entity Type | Organization
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Legal Business Name | EXCELA HEALTH PHYSICIAN PRACTICES, INC.
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 532 W PITTSBURGH ST
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City | GREENSBURG
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State | PA
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Zip | 15601-2239
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Country | US
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Telephone | 724-832-4189
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Fax |
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Provider Business Mailing Address
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Address Line | 134 INDUSTRIAL PARK RD STE 1500
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City | GREENSBURG
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State | PA
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Zip | 15601-8153
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Country | US
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Telephone | 724-850-6933
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Fax | 724-522-4002
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | RENEE M VARNEY
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Credential |
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Telephone | 724-850-6933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number |
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License Number State |
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