Provider Demographics
NPI:1497726046
Name:MAREDA, PATRICIA T (CRNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:T
Last Name:MAREDA
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 1:420 E NORTH AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4746
Mailing Address - Country:US
Mailing Address - Phone:412-369-3426
Mailing Address - Fax:412-359-6974
Practice Address - Street 1:420 E NORTH AVE
Practice Address - Street 2:STE 205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4746
Practice Address - Country:US
Practice Address - Phone:412-369-3426
Practice Address - Fax:412-359-6974
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP002095B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S34642Medicare UPIN
MA764587Medicare ID - Type Unspecified