MEDICARE: CONNIE COBLE-ROE 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	363L00000X	Nurse Practitioner	UP003875B	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548241110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE COBLE-ROE CRNP

Provider Business Mailing Address
First Line	:	200 LOTHROP ST
Second Line	:	FORBES TOWER, SUITE 10055-B
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-2536
Country	:	US
Telephone Number	:	412-647-3222
Fax Number	:	412-647-3222

Provider Business Practice Location Address
First Line	:	5 SAINT FRANCIS WAY
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5119
Country	:	US
Telephone Number	:	724-814-6068
Fax Number	:

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	10/29/2015

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