Individual
MICA L VANFOSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 LEWIS RUN RD, SUITE 202, PITTSBURGH, PA 15122-3056
(412) 469-6964
(412) 469-6948
Mailing address
100 MEDICAL BLVD, CANONSBURG, PA 15317-9762
(412) 359-6581
(412) 359-3483
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
RN307612L
PA
Other
Enumeration date
05/05/2006
Last updated
10/13/2020
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