Individual
MARIA LISA MCMYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
746 JEFFERSON AVE, SCRANTON, PA 18510-1624
(570) 770-3000
Mailing address
508 S KEYSER AVE, SCRANTON, PA 18504-9748
(570) 677-0588
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
650668
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN650668
PA
Other
Enumeration date
11/13/2020
Last updated
04/05/2021
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