Basic Information
| Provider Information | |||||||||
| NPI: | 1336117654 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRISKO-STOKES | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 FRIENDSHIP AVE | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152241722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125785323 | ||||||||
| FaxNumber: | 4126056425 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177823282 | ||||||||
| FaxNumber: | 7172318964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2006 | ||||||||
| LastUpdateDate: | 10/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN234392L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | P00390654 | 01 | PA | RAILROAD MEDICARE | OTHER | 001963390 | 05 | PA | MEDICAID |