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General NPI Number Information
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NPI Number | 1598851123
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Entity Type | Individual
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Provider Name | MICHELLE KRYSAK RN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 NEW SALEM ROAD SUITE 116
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City | UNIONTOWN
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State | PA
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Zip | 15401-8936
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Country | US
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Telephone | 724-437-0729
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Fax | 724-437-2761
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Provider Business Mailing Address
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Address Line | 100 NEW SALEM ROAD SUITE 116
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City | UNIONTOWN
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State | PA
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Zip | 15401-8936
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Country | US
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Telephone | 724-437-0729
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Fax | 724-437-2761
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN506275-L
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License Number State | PA
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