Individual
MS. MARY ELIZABETH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BS,BSN
Contact information
Practice address
BUSINESS ROUTE 209 AND BOSSARDSVILLE ROAD, SCIOTA, PA 18354
(570) 992-6300
(570) 402-2900
Mailing address
PO BOX 507, SCIOTA, PA 18354-0507
(570) 992-6300
(570) 402-2900
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
RN243814L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016671410002
—
PA
Enumeration date
10/24/2007
Last updated
10/24/2007
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