Individual
MRS. ROSEANN STASKO KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10455 LINCOLN HWY, EVERETT, PA 15537-7046
(814) 623-6161
(814) 623-3535
Mailing address
200 LOTHROP ST, FORBES TOWER, SUITE 9055, PITTSBURGH, PA 15213-2536
(412) 647-3087
(412) 647-4486
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN161128L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
873768
BLUE SHIELD
PA
Enumeration date
01/05/2007
Last updated
03/21/2011
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