MEDICARE: SANDRA KITCHO 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	SP023978	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP023978	OTHER	PA	CRNP LICENSE NUMBER

General Provider Information

NPI Number	:	1740852581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA KITCHO CRNP

Provider Business Mailing Address
First Line	:	2357 BEAUFORT AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15226-1534
Country	:	US
Telephone Number	:	707-816-6139
Fax Number	:

Provider Business Practice Location Address
First Line	:	HILLTOP COMMUNITY HEALTH CENTER
Second Line	:	151 RUTH STREET
City	:	PITTSBURGH
State	:	PA
Zip	:	15211-2384
Country	:	US
Telephone Number	:	412-431-3520
Fax Number	:	412-431-3520

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

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	11/12/2024

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