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NPI Code Detail

MEDICARE: MS. MARY EILEEN MCSORLEY CRNP

MEDICARE:  MS. MARY EILEEN MCSORLEY  CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerSP006593BPA

General Provider Information

NPI Number : 1023150570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY EILEEN MCSORLEY CRNP
Provider Business Mailing Address
First Line : PO BOX 746722
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6722
Country : US
Telephone Number : 469-727-6675
Fax Number :
Provider Business Practice Location Address
First Line : 3621 ARAMINGO AVE STE 5C
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-4607
Country : US
Telephone Number : 215-444-7472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 06/09/2025

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