Provider Demographics
NPI:1114141777
Name:NOVIC, KRISTIN MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARIE
Last Name:NOVIC
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:402 PAPPAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:PA
Mailing Address - Zip Code:15126
Mailing Address - Country:US
Mailing Address - Phone:724-513-5678
Mailing Address - Fax:724-695-9259
Practice Address - Street 1:ALLEGHENY GENERAL HOSPITAL
Practice Address - Street 2:320 EAST NORTH AVENUE, 6TH FLOOR, SOUTH TOWER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212
Practice Address - Country:US
Practice Address - Phone:412-359-5036
Practice Address - Fax:412-359-3305
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMA051134363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant