Individual
KACIE ANGELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4401 PENN AVE, PITTSBURGH, PA 15224-1334
(412) 692-5030
(412) 692-6691
Mailing address
4401 PENN AVE, PITTSBURGH, PA 15224-1334
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
SP014136
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103419421
—
PA
Enumeration date
09/18/2014
Last updated
10/08/2020
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