MEDICARE: DAVID HUMPHREYS CRNP-MSN

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	363LA2100X	Acute Care Nurse Practitioner	SP008735	PA

General Provider Information

NPI Number	:	1861440992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID HUMPHREYS CRNP-MSN

Provider Business Mailing Address
First Line	:	634 ALPHA DR
Second Line	:	SUITE 600
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2802
Country	:	US
Telephone Number	:	610-892-8991
Fax Number	:

Provider Business Practice Location Address
First Line	:	634 ALPHA DR
Second Line	:	SUITE 600
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2802
Country	:	US
Telephone Number	:	610-892-8991
Fax Number	:

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	05/09/2014

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