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Individual
NINO KAVTARADZE
Active
Individual
NINO KAVTARADZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN632493
PA
363L00000X
Nurse Practitioner
Primary
SP015632
PA
363LF0000X
Family Nurse Practitioner
SP015632
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032670520017
—
PA
01
—
33402683
AMERICAN NURSES CREDENTIALING CENTER (ANCC)
—
01
—
RN632493
PENNSYLVANIA DEPARTMENT OF STATE
PA
01
—
SP015632
PENNSYLVANIA DEPARTMENT OF STATE
PA
Enumeration date
10/30/2014
Last updated
11/27/2023
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