Individual
LARISSA NICOLE BISTARKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-6581
(412) 359-3483
Mailing address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-6581
(412) 359-3483
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN641619
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
130257
PA
Other
Enumeration date
11/17/2019
Last updated
10/09/2020
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