Provider Demographics
NPI:1366749996
Name:CALLIHAN, MICHAELLE PATRICIA (CRNP)
Entity type:Individual
Prefix:
First Name:MICHAELLE
Middle Name:PATRICIA
Last Name:CALLIHAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MICHAELLE
Other - Middle Name:PATRICIA
Other - Last Name:CALLIHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
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:412-369-3030
Mailing Address - Fax:412-369-3060
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-369-3030
Practice Address - Fax:412-369-3060
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011265363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA213912Medicare PIN