Basic Information
| Provider Information | |||||||||
| NPI: | 1982162020 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEORGE | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2966 OLD ROUTE 56 HWY W | ||||||||
| Address2: | |||||||||
| City: | HOMER CITY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157487603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245498382 | ||||||||
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| Practice Location | |||||||||
| Address1: | 835 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157013629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243577000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2019 | ||||||||
| LastUpdateDate: | 03/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 125006 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.