Provider Demographics
NPI:1386675932
Name:KREINBROOK, TONIA R (CRNP)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:R
Last Name:KREINBROOK
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 1:201 N PITTSBURGH ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-3231
Mailing Address - Country:US
Mailing Address - Phone:724-628-4450
Mailing Address - Fax:724-626-2580
Practice Address - Street 1:201 N PITTSBURGH ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-3231
Practice Address - Country:US
Practice Address - Phone:724-628-4450
Practice Address - Fax:724-626-2580
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004974W363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020465EUDMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
PAS65061Medicare UPIN
PA500017700Medicare ID - Type UnspecifiedRAILROAD MEDICARE ID#