Provider Demographics
NPI:1538152897
Name:MALONE, VICTORIA L (CRNA)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:L
Last Name:MALONE
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3155
Mailing Address - Fax:412-359-3483
Practice Address - Street 1:631 NORTH BROAD STREET EXT.
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4603
Practice Address - Country:US
Practice Address - Phone:724-458-5442
Practice Address - Fax:724-450-7251
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2021-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PARN340744L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS68629Medicare UPIN