MEDICARE: MRS. ROSANNA M GARTLEY RN, 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
1	363LF0000X	Family Nurse Practitioner	SP007827	PA

General Provider Information

NPI Number	:	1346249141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSANNA M GARTLEY RN, CRNP

Provider Business Mailing Address
First Line	:	1973 EDMON RD
Second Line	:
City	:	EDMON
State	:	PA
Zip	:	15618-1277
Country	:	US
Telephone Number	:	724-697-4641
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 GRAHAM ST
Second Line	:
City	:	MC KEES ROCKS
State	:	PA
Zip	:	15136-2755
Country	:	US
Telephone Number	:	412-778-4720
Fax Number	:	412-778-4759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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