Provider Demographics
NPI:1396225629
Name:KARIMI, CASSANDRA M (CRNP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:M
Last Name:KARIMI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:M
Other - Last Name:TONKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:5171 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2254
Mailing Address - Country:US
Mailing Address - Phone:412-683-4550
Mailing Address - Fax:412-246-4567
Practice Address - Street 1:5171 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2254
Practice Address - Country:US
Practice Address - Phone:412-683-4550
Practice Address - Fax:412-246-4567
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019092363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036119430001Medicaid