Individual
BREANNA BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 LOCUST ST, SUITE 100 A, PITTSBURGH, PA 15219-5114
(412) 232-8111
Mailing address
11279 PERRY HWY STE 450, SUITE 100 A, WEXFORD, PA 15090-9303
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP018582
PA
Other
Enumeration date
02/21/2018
Last updated
05/24/2021
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