Provider Demographics
NPI:1457769176
Name:UPMC ADVANCED PRACTICE PROVIDERS
Entity Type:Organization
Organization Name:UPMC ADVANCED PRACTICE PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRODINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0548
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:FORBES TOWER, SUITE 10055-B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-864-0594
Mailing Address - Fax:412-647-3222
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:FORBES TOWER, SUITE 10055-B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-864-0594
Practice Address - Fax:412-647-3222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPMC COMMUNITY PROVIDER SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-25
Last Update Date:2015-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA372689Medicare PIN