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NPI Code Detail

MEDICARE: KIMBERLY OTT CRNP

MEDICARE:   KIMBERLY  OTT  CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerSP03535BPA

General Provider Information

NPI Number : 1235101692
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY OTT CRNP
Provider Business Mailing Address
First Line : 600 GRANT ST FL 58
Second Line :
City : PITTSBURGH
State : PA
Zip : 15219-2702
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9100 BABCOCK BLVD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15237-5815
Country : US
Telephone Number : 412-748-6454
Fax Number : 412-748-5249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 10/06/2021

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Directions to “ KIMBERLY OTT CRNP” Practice Location

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