Provider Demographics
NPI:1073109344
Name:ABERCROMBIE, KEVIN
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:ABERCROMBIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 BRANDYWINE DR
Mailing Address - Street 2:7TH FLOOR FRANK SARRIS CLINIC
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-9225
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3471 5TH AVE BLDG SUITE201
Practice Address - Street 2:7TH FLOOR FRANK SARRIS CLINIC
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3215
Practice Address - Country:US
Practice Address - Phone:412-647-1170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily