Provider Demographics
NPI:1982162020
Name:GEORGE, ANGELA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2966 OLD ROUTE 56 HWY W
Mailing Address - Street 2:
Mailing Address - City:HOMER CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15748-7603
Mailing Address - Country:US
Mailing Address - Phone:724-549-8382
Mailing Address - Fax:
Practice Address - Street 1:835 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3629
Practice Address - Country:US
Practice Address - Phone:724-357-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA125006367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered