Basic Information
| Provider Information | |||||||||
| NPI: | 1326689423 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOHN | ||||||||
| FirstName: | KELSEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4815 LIBERTY AVE STE 215 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152242156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125785901 | ||||||||
| FaxNumber: | 4125785902 | ||||||||
| Practice Location | |||||||||
| Address1: | 4815 LIBERTY AVE STE 215 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152242156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125785901 | ||||||||
| FaxNumber: | 4125785902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2019 | ||||||||
| LastUpdateDate: | 10/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | SP020396 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.