Provider Demographics
NPI:1245301753
Name:YAUGER, MELISSA ANN (CRNA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:YAUGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3155
Mailing Address - Fax:412-359-3483
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-5323
Practice Address - Fax:412-605-6425
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2022-11-03
Deactivation Date:2018-12-12
Deactivation Code:
Reactivation Date:2018-12-19
Provider Licenses
StateLicense IDTaxonomies
WVAPRN46202CRNA367500000X
PARN344363L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA220307OtherUPMC
PACO1682275OtherBLUE SHIELD
WV0207026000OtherMEDICAID GROUP
WV9333201OtherMEDICARE GROUP
PACO1682275OtherBLUE SHIELD
WV9333201OtherMEDICARE GROUP