Provider Demographics
NPI:1184806903
Name:TEDESCO, MARY BETH (CRNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:TEDESCO
Suffix:
Gender:F
Credentials:CRNP, FNP-BC
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:BETH
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1116 DUFFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1317
Mailing Address - Country:US
Mailing Address - Phone:412-441-9453
Mailing Address - Fax:412-441-1619
Practice Address - Street 1:3459 5TH AVE
Practice Address - Street 2:EMRC - NW 810 UPMC MONTEFIORE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3236
Practice Address - Country:US
Practice Address - Phone:412-864-3265
Practice Address - Fax:412-692-2165
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP002333B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily