Provider Demographics
NPI:1659707917
Name:MAHOLAGE, KASEY ROYCE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:ROYCE
Last Name:MAHOLAGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2570 HAYMAKER RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-858-2000
Mailing Address - Fax:
Practice Address - Street 1:ONE CHILDREN'S HOSPITAL DRIVE
Practice Address - Street 2:4401 PENN AVENUE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-5260
Practice Address - Fax:412-692-8658
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN582620367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered