Provider Demographics
NPI:1932347358
Name:KNECHTEL, MARY ANN (RN, CRNP-BC, ANP,GNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:KNECHTEL
Suffix:
Gender:F
Credentials:RN, CRNP-BC, ANP,GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 DUTCHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-0620
Mailing Address - Country:US
Mailing Address - Phone:724-282-0014
Mailing Address - Fax:
Practice Address - Street 1:2275 SWALLOW HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1656
Practice Address - Country:US
Practice Address - Phone:412-279-4522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-284406-LPA163W00000X
NYRN-525897-LNY163W00000X
PAANP-SP008134363LA2200X
PAGNP-SP007994363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRN-525897-LNYOtherREGISTERD NURSE
PAGNP-SP007994OtherGERIATIRC NURSE PRACTITIONER
PARN-284406-L PAOtherREGISTERED NURSE
PAANP-SP008134OtherADULT NURSE PRACTITIONER