Individual
MARY LOU MACKIEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
918 3RD AVE, BEAVER FALLS, PA 15010-4613
(724) 843-6000
Mailing address
530 PATTERSON RD, NEW GALILEE, PA 16141-4616
(724) 336-4984
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP000841A
PA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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