Provider Demographics
NPI:1386077188
Name:HEITZENRATER, KRISTIN MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:HEITZENRATER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:MARIE
Other - Last Name:HASIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:651 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-2740
Mailing Address - Country:US
Mailing Address - Phone:412-922-8490
Mailing Address - Fax:412-921-1194
Practice Address - Street 1:651 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-2740
Practice Address - Country:US
Practice Address - Phone:412-922-8490
Practice Address - Fax:412-921-1194
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013023363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner