Individual
MRS. TIFFANY D. PELLATHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3000 VILLAGE RUN RD, BLDG. 103-202, WEXFORD, PA 15090-6315
(412) 867-9585
Mailing address
3000 VILLAGE RUN RD, BLDG. 103-202, WEXFORD, PA 15090-6315
(412) 867-9585
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
AC000410
MD
363LA2100X
Acute Care Nurse Practitioner
Primary
AC000410
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415096100
—
MD
Enumeration date
11/22/2006
Last updated
01/31/2011
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