Individual
MARY MULLEN-WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5 MORGAN HWY, SUITE 4, SCRANTON, PA 18508-2641
(570) 344-3788
(570) 969-9280
Mailing address
5 MORGAN HWY, SUITE 4, SCRANTON, PA 18508-2641
(570) 344-3788
(570) 969-9280
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
VP005831B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027924
BLUE CARE
PA
05
—
103062761-0001
—
PA
01
—
50076570
CAPITAL BLUE CROSS
PA
01
—
P00293834
RAILROAD MEDICARE
PA
Enumeration date
09/15/2005
Last updated
01/24/2020
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