Individual
MARY WHIPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
149 W 22ND ST, ERIE, PA 16502-2804
(814) 456-5433
Mailing address
149 W 22ND ST, ERIE, PA 16502-2804
(814) 456-5433
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP014509
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP014509
COMMONWEALTH OF PENNSYLVANIA BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PA
Enumeration date
05/18/2015
Last updated
05/18/2015
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