Provider Demographics
NPI:1275297962
Name:PLETCHER, MIKAELA R (CRNP)
Entity Type:Individual
Prefix:
First Name:MIKAELA
Middle Name:R
Last Name:PLETCHER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MIKAELA
Other - Middle Name:R
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:5200 CENTRE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1312
Mailing Address - Country:US
Mailing Address - Phone:412-578-9747
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE STE 203
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1312
Practice Address - Country:US
Practice Address - Phone:412-578-9747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily