Provider Demographics
NPI:1851354757
Name:SPIVAK, MEGAN CATHARINE (CRNA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CATHARINE
Last Name:SPIVAK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:CATHARINE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2570 HAYMAKER RD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3513
Mailing Address - Country:US
Mailing Address - Phone:412-858-4485
Mailing Address - Fax:412-858-3190
Practice Address - Street 1:2570 HAYMAKER RD DEPT OF
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-4485
Practice Address - Fax:412-858-3190
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-510577-L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P43729Medicare UPIN