Individual
MARY WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
601 N FRONT ST, PHILIPSBURG, PA 16866-2303
(814) 342-2333
(814) 342-2277
Mailing address
601 N FRONT STREET, PHILIPSBURG, PA 16866
(814) 342-2333
(814) 342-2277
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010179
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP010179
STATE LICENSE
PA
Enumeration date
11/03/2015
Last updated
11/16/2015
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