Provider Demographics
NPI:1760798391
Name:ELLIOTT, KATHI RENEE (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHI
Middle Name:RENEE
Last Name:ELLIOTT
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:VA PITTSBURGH HEALTH SYSTEM
Mailing Address - Street 2:UNIVERSITY DRIVE C
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-292-8569
Mailing Address - Fax:
Practice Address - Street 1:5543 HAYS ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-2006
Practice Address - Country:US
Practice Address - Phone:412-292-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010251363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health