Individual
CATHLEEN C MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Mailing address
1 GUTHRIE SQ, PROVIDER ENROLLMENT DEPARTMENT, SAYRE, PA 18840-1625
(570) 882-3025
(570) 882-3023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN549773
PA
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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