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Individual

MARY ELLEN HICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
100 FAIRFIELD DR, SENECA, PA 16346-2130
(814) 676-7843
(814) 676-7838
Mailing address
100 FAIRFIELD DR, SENECA, PA 16346-2130
(814) 676-7843
(814) 676-7838

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN153354L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019607640001
PA
05
0019613040001
PA
01
050555457
COMMERCIAL BLK 33 GRP
PA
01
072952
BLUE SHIELD BLK 33 PIN
PA
01
1520056
BLUE SHIELD BLK 33 GRP
PA
01
312161
UPMC BLK 33 PIN
PA
01
808862
BLUE SHIELD BLK 33 GRP
PA
01
994588
BLUE SHIELD BLK 33 PIN
PA
01
DD4802
PALMETTO GBA BLK 33 GRP
PA
01
P00230587
PALMETTO GBA BLK 33 PIN
PA
01
R88943
COMMERCIAL BLK 33 PIN
PA
Enumeration date
07/09/2006
Last updated
01/29/2012
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