Provider Demographics
NPI:1487625315
Name:MAUSER, TRACY L (CRNA)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:L
Last Name:MAUSER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:L
Other - Last Name:WOLOSHYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1657 STURBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8514
Mailing Address - Country:US
Mailing Address - Phone:412-548-3299
Mailing Address - Fax:
Practice Address - Street 1:4800 FRIENDSHIP AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-1354
Practice Address - Fax:412-578-4981
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN502087L367500000X, 163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA052378OtherCRNA RECERT
PAP00390174OtherRAILROAD MEDICARE
PARN502087LOtherREGISTERED NURSE LICENSE
PA23273409OtherDRIVERS LICENSE
PAP00390174OtherRAILROAD MEDICARE