Individual
MRS. MARY ELIZABETH LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5 N 3RD ST, REYNOLDSVILLE, PA 15851-0907
(814) 653-8222
(814) 653-9305
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6549
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP018275
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP018275
CRNP LICENSE
PA
Enumeration date
12/07/2017
Last updated
02/14/2024
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