Provider Demographics
NPI:1972738961
Name:GIFFORD, KRISTINA FERENAC (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:FERENAC
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OXFORD DRIVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-283-0260
Mailing Address - Fax:412-283-0070
Practice Address - Street 1:2000 OXFORD DRIVE
Practice Address - Street 2:SUITE 211
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-283-0260
Practice Address - Fax:412-283-0070
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053825363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical