Basic Information
| Provider Information | |||||||||
| NPI: | 1932347358 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KNECHTEL | ||||||||
| FirstName: | MARY ANN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN, CRNP-BC, ANP,GNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 332 DUTCHTOWN RD | ||||||||
| Address2: | |||||||||
| City: | BUTLER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160020620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242820014 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2275 SWALLOW HILL RD | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152201656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122794522 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2009 | ||||||||
| LastUpdateDate: | 05/16/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN-284406-LPA | PA | N | Nursing Service Providers | Registered Nurse | 163W00000X | RN-525897-LNY | NY | N | Nursing Service Providers | Registered Nurse | 363LA2200X | ANP-SP008134 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LG0600X | GNP-SP007994 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
ID Information
| ID | Type | State | Issuer | Description | RN-525897-LNY | 01 | NY | REGISTERD NURSE | OTHER | GNP-SP007994 | 01 | PA | GERIATIRC NURSE PRACTITIONER | OTHER | RN-284406-L PA | 01 | PA | REGISTERED NURSE | OTHER | ANP-SP008134 | 01 | PA | ADULT NURSE PRACTITIONER | OTHER |