Provider Demographics
NPI:1992460570
Name:KRESSE, ANNA SOPHIA (PA-C)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:SOPHIA
Last Name:KRESSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 BLACKBURN RD FL 1
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1459
Mailing Address - Country:US
Mailing Address - Phone:412-741-0985
Mailing Address - Fax:
Practice Address - Street 1:720 BLACKBURN RD FL 1
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1459
Practice Address - Country:US
Practice Address - Phone:412-741-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063227363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant