Provider Demographics
NPI:1003366410
Name:WILLEY, RELDA (CRNP)
Entity type:Individual
Prefix:
First Name:RELDA
Middle Name:
Last Name:WILLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:341 S BELLEFIELD AVE
Mailing Address - Street 2:ROOM 430
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3552
Mailing Address - Country:US
Mailing Address - Phone:412-529-6623
Mailing Address - Fax:
Practice Address - Street 1:845 MCLAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-1043
Practice Address - Country:US
Practice Address - Phone:412-529-6623
Practice Address - Fax:412-224-4742
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAUP006618W363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool