1093786006 NPI number — DEBRA K CORREA CRNP

Table of content: DEBRA K CORREA CRNP (NPI 1093786006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093786006 NPI number — DEBRA K CORREA CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORREA
Provider First Name:
DEBRA
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093786006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HOT METAL ST
Provider Second Line Business Mailing Address:
QUANTUM ONE, N431
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15203-2348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-432-5806
Provider Business Mailing Address Fax Number:
412-432-7691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 PINE HOLLOW RD
Provider Second Line Business Practice Location Address:
SUITE 1A
Provider Business Practice Location Address City Name:
MC KEES ROCKS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15136-1516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-771-9561
Provider Business Practice Location Address Fax Number:
412-771-5296
Provider Enumeration Date:
01/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  SP003754B , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11676854 . This is a "CAQH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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