Provider Demographics
NPI:1740633361
Name:KURIAN, CICILY (CRNP)
Entity type:Individual
Prefix:
First Name:CICILY
Middle Name:
Last Name:KURIAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ESLA
Other - Middle Name:
Other - Last Name:KADALIKKATTIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:341 S BELLEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3552
Mailing Address - Country:US
Mailing Address - Phone:412-529-3803
Mailing Address - Fax:
Practice Address - Street 1:341 S BELLEFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3552
Practice Address - Country:US
Practice Address - Phone:412-529-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005619W364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics