Individual
MISS STACEY MARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6211
Mailing address
18 YOCUM DR, BLOOMSBURG, PA 17815-7710
(570) 854-7753
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN594705
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103113047
—
PA
Enumeration date
10/30/2013
Last updated
08/30/2016
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