Individual
MRS. MARCIA TAYLOR WERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
420 E CENTRAL WAY, BEDFORD, PA 15522-1457
(814) 623-3474
(814) 623-3022
Mailing address
420 E CENTRAL WAY, BEDFORD, PA 15522-1457
(814) 623-3474
(814) 623-3022
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP010053
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007307260037
MEDICAID GROUP #
PA
05
—
102368696
—
PA
01
—
25-1716306
INTERGROUP
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
P00768400
RAILROAD MEDICARE
PA
01
—
SP010053
LICENSE
PA
Enumeration date
11/14/2008
Last updated
03/07/2023
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