Individual
MARY BARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
635 MAPLE AVENUE, DUBOIS, PA 15801
(814) 375-6379
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6351
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP019616
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP019616
CRNP LICENSE
PA
Enumeration date
11/26/2018
Last updated
11/26/2018
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