Basic Information
Provider Information
NPI: 1649863143
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARTOLONE
FirstName: DONNA
MiddleName: LYNN
NamePrefix: MRS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 438 SHELBOURNE DR
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152393604
CountryCode: US
TelephoneNumber: 3305023889
FaxNumber:  
Practice Location
Address1: 1400 LOCUST ST
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152195114
CountryCode: US
TelephoneNumber: 4122328111
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/16/2021
LastUpdateDate: 02/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP022933PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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