MRS. TIFFANY D. PELLATHY


Address: 3000 Village Run Rd, Bldg. 103-202, Wexford, PA 15090-6315
Phone: 4128679585

MRS. TIFFANY D. PELLATHY (NPI# 1558436774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558436774
Entity Type Individual
Full Name MRS. TIFFANY D. PELLATHY
Other Name MRS. TIFFANY D. PURCELL
Credential CRNP
Practice Address 3000 Village Run Rd
Bldg. 103-202
Wexford
PA 15090-6315
Practice Telephone 4128679585
Mailing Telephone 4128679585
Enumeration Date 2006-11-22
Last Update Date 2011-01-31
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363AM0700X Physician Assistant
Specialization: Medical
AC000410 MD Physician Assistants & Advanced Practice Nursing Providers
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
AC000410 MD Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MD 415096100 05

Office Location

Street Address 3000 VILLAGE RUN RD
BLDG. 103-202
City WEXFORD
State PA
Zip Code 15090-6315

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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

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Competitor

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City WEXFORD
Zip Code 15090

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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