Provider Demographics
NPI:1437389624
Name:PERICH, KATHLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PERICH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:11279 PERRY HWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9381
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:1925 ROUTE 51
Practice Address - Street 2:
Practice Address - City:LARGE
Practice Address - State:PA
Practice Address - Zip Code:15025-3681
Practice Address - Country:US
Practice Address - Phone:412-384-9030
Practice Address - Fax:412-384-9038
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP001950D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics