Provider Demographics
NPI:1629193685
Name:DAVID, CHARLENE M (APRN,BC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:M
Last Name:DAVID
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 CAVAN DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4341
Mailing Address - Country:US
Mailing Address - Phone:412-650-8443
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-3817
Practice Address - Country:US
Practice Address - Phone:412-688-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN270028364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health