Provider Demographics
NPI:1467588194
Name:HARALAM, MARY ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:HARALAM
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 1:415 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15236-1443
Mailing Address - Country:US
Mailing Address - Phone:412-650-6126
Mailing Address - Fax:412-650-6126
Practice Address - Street 1:3705 FIFTH AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2583
Practice Address - Country:US
Practice Address - Phone:412-692-8582
Practice Address - Fax:412-692-8589
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000499D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics