| Mrs Mary Elizabeth Logan, CRNP | |
|
5 N 3rd St, Reynoldsville, PA 15851-0907 | |
| (814) 653-8222 | |
| (814) 653-9305 |
| Full Name | Mrs Mary Elizabeth Logan |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 5 N 3rd St, Reynoldsville, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962917245 | NPI | - | NPPES |
| SP018275 | Other | PA | CRNP LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | SP018275 (Pennsylvania) | Primary |
| Entity Name | Dubois Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245410554 PECOS PAC ID: 5890689715 Enrollment ID: O20040426000432 |
| Entity Name | Dubois Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487937199 PECOS PAC ID: 5890689715 Enrollment ID: O20111107000034 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Mary Elizabeth Logan, CRNP 100 Hospital Ave, Du Bois, PA 15801-1440 Ph: (814) 375-6549 | Mrs Mary Elizabeth Logan, CRNP 5 N 3rd St, Reynoldsville, PA 15851-0907 Ph: (814) 653-8222 |
Amanda Lace Irwin, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6514 Sulgar Rd, Reynoldsville, PA 15851 Phone: 814-591-5046 | |
Sharon Gilmore, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5 N 3rd St, Reynoldsville, PA 15851 Phone: 814-653-8222 Fax: 814-653-9305 |