Provider Demographics
NPI:1891033551
Name:HESS, KELLY MARISA (PA)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:MARISA
Last Name:HESS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:MARISA
Other - Last Name:BARNHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2575 BOYCE PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3925
Mailing Address - Country:US
Mailing Address - Phone:412-257-2290
Mailing Address - Fax:
Practice Address - Street 1:2575 BOYCE PLAZA RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3925
Practice Address - Country:US
Practice Address - Phone:412-257-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055984363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant