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General NPI Number Information
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NPI Number | 1861042913
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Entity Type | Individual
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Provider Name | KRISTY DESOMMA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 107 GAMMA DR STE 210
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City | PITTSBURGH
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State | PA
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Zip | 15238-2936
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Country | US
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Telephone | 412-963-6677
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Fax |
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Provider Business Mailing Address
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Address Line | 213 WATERFORD DR
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City | MC KEES ROCKS
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State | PA
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Zip | 15136-1375
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Country | US
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Telephone | 660-624-9952
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP020823
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License Number State | PA
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