Provider Demographics
NPI:1407922826
Name:KVERAGAS, ANN M (RN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:KVERAGAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6933 LOOP RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-4350
Mailing Address - Country:US
Mailing Address - Phone:814-667-3412
Mailing Address - Fax:
Practice Address - Street 1:500 E CHESTNUT AVE
Practice Address - Street 2:NFP
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3478
Practice Address - Country:US
Practice Address - Phone:814-942-1903
Practice Address - Fax:814-505-1100
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN189124L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015939710001Medicaid