Provider Demographics
NPI:1750547253
Name:ENGBERG, MARIE C (CRNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:ENGBERG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:901-B WEST STREET
Mailing Address - Street 2:METRO FAMILY PRACTICE, INC.
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221
Mailing Address - Country:US
Mailing Address - Phone:412-247-2310
Mailing Address - Fax:412-247-2373
Practice Address - Street 1:901-B WEST STREET
Practice Address - Street 2:METRO FAMILY PRACTICE, INC.
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221
Practice Address - Country:US
Practice Address - Phone:412-247-2310
Practice Address - Fax:412-247-2373
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP009889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP009889OtherLICENSE NUMBER