Individual
STACY NIDITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5115 CENTRE AVE, PITTSBURGH, PA 15232-1301
(570) 220-5864
Mailing address
5115 CENTRE AVE, PITTSBURGH, PA 15232-1301
(570) 220-5864
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
TP003172C
PA
Other
Enumeration date
07/30/2013
Last updated
07/17/2023
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