| NPI | 1659321164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Director Credentialing 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-03-31 |