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Individual

MARY JANE SMALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1645 WEST 8TH STREET, SHRINERS HOSPITALS FOR CHILDREN ERIE, ERIE, PA 16505-5097
(800) 873-5437
(814) 875-8796
Mailing address
P O BOX 8500, SHRINERS HOSPITALS FOR CHILDREN LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(813) 281-8478
(813) 281-8113

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
382009
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
SP009524
PA

Other

Enumeration date
09/16/2008
Last updated
10/08/2012
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