Provider Demographics
NPI:1922434984
Name:KNOWLSON, STEPHANIE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:KNOWLSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:COLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:141 CAREYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WAMPUM
Mailing Address - State:PA
Mailing Address - Zip Code:16157-2501
Mailing Address - Country:US
Mailing Address - Phone:814-558-5045
Mailing Address - Fax:
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN604827367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered