# PROBST FAMILY PRACTICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518710334
- **Authorized official:** KRISTEN PROBST (MANAGER)
- **Authorized official phone:** (570) 927-0865

## Contact information

- **Practice address:** 924 HURON AVE, RENOVO, PA 17764-1142
- **Practice address phone:** (412) 655-4362
- **Mailing address:** PO BOX 791, CARNEGIE, PA 15106-0791
- **Mailing address phone:** (570) 927-0865
- **Mailing address fax:** (412) 504-7702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2024
- **Last updated:** 04/09/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | OS00065L | STATE LICENSE | PA |