Individual
MRS. MARY JACQUELINE HERBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1800 MULBERRY ST, SCRANTON, PA 18510-2369
(570) 969-1800
Mailing address
478 SLOCUM ST, SWOYERSVILLE, PA 18704-1947
(570) 287-3225
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
078124
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020751570001
—
PA
Enumeration date
10/30/2007
Last updated
04/01/2008
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