Provider Demographics
NPI:1720442593
Name:LAMBERT, KELLY (RN MSN)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1105 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2114
Practice Address - Country:US
Practice Address - Phone:412-377-2363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN640366163WG0000X, 163WR0400X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health