Provider Demographics
NPI:1932747540
Name:REKASIE, JOSEPHINE M (CRNP)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:M
Last Name:REKASIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 MCKNIGHT EAST DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6400
Mailing Address - Country:US
Mailing Address - Phone:412-369-9943
Mailing Address - Fax:412-369-9447
Practice Address - Street 1:3601 MCKNIGHT EAST DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6400
Practice Address - Country:US
Practice Address - Phone:412-369-9943
Practice Address - Fax:412-369-9447
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily