Basic Information
| Provider Information | |||||||||
| NPI: | 1750554119 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALLEGHENY MEDICAL PRACTICE NETWORK | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | FAMILY NURSE MIDWIVES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 7546 ROUTE 30 | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | IRWIN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156427528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247651031 | ||||||||
| FaxNumber: | 7247651035 | ||||||||
| Practice Location | |||||||||
| Address1: | 7546 ROUTE 30 | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | IRWIN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156427528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247651031 | ||||||||
| FaxNumber: | 7247651035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2008 | ||||||||
| LastUpdateDate: | 05/15/2008 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | WALTEMIRE | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGED CARE SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 4123305523 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Midwife |
No ID Information.