Provider Demographics
NPI:1578331005
Name:MCINTYRE, STEVEN GERALD (CRNP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:GERALD
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 2ND ST STE 401
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1577
Mailing Address - Country:US
Mailing Address - Phone:814-877-7310
Mailing Address - Fax:814-877-7320
Practice Address - Street 1:120 E 2ND ST STE 401
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1577
Practice Address - Country:US
Practice Address - Phone:814-877-7310
Practice Address - Fax:814-877-7320
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028935363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner