Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP020449 | PA |
NPI | 1023470929 |
---|---|
Provider Name | Keona Pagley |
First Address | New Castle, PA 16105-2516 |
Second Address | Pittsburgh, PA 15213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 17/06/2021 |