Provider Demographics
NPI:1730218611
Name:ROSS, CARL A (CRNP)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:A
Last Name:ROSS
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5233
Mailing Address - Country:US
Mailing Address - Phone:412-364-2664
Mailing Address - Fax:412-364-8037
Practice Address - Street 1:8150 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5232
Practice Address - Country:US
Practice Address - Phone:412-364-2664
Practice Address - Fax:412-364-8037
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008486363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA088515Medicare ID - Type Unspecified
PAQ37449Medicare UPIN