Provider Demographics
NPI:1235680083
Name:SANI, KATRINA L (CRNP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:L
Last Name:SANI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 LIBERTY AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2215
Mailing Address - Country:US
Mailing Address - Phone:412-578-3306
Mailing Address - Fax:412-605-6446
Practice Address - Street 1:850 BOYCE RD STE 2
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1541
Practice Address - Country:US
Practice Address - Phone:724-263-9322
Practice Address - Fax:724-942-3178
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103233410Medicaid