Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP014343 | PA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP014343 | PA |
NPI | 1235528373 |
---|---|
Provider Name | Katybeth Mcclelland |
First Address | Pittsburgh, PA 15224-1722 |
Second Address | Pittsburgh, PA 15224-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2015 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103114204 | (05) | PA |