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NPI Code Detail

MEDICARE: MRS. MARY GLENN SHUART MSN, CRNP

MEDICARE: MRS. MARY GLENN SHUART MSN, 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
1163WP0808XPsychiatric/Mental Health Registered NurseRN560645PA
2364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist26NJ00137900NJ
3363LP0808XPsychiatric/Mental Health Nurse PractitionerSP010760PA

General Provider Information

NPI Number : 1407904030
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY GLENN SHUART MSN, CRNP
Provider Business Mailing Address
First Line : 500 N WEST ST
Second Line :
City : DOYLESTOWN
State : PA
Zip : 18901-2366
Country : US
Telephone Number : 215-345-5300
Fax Number :
Provider Business Practice Location Address
First Line : 500 N WEST ST
Second Line :
City : DOYLESTOWN
State : PA
Zip : 18901-2366
Country : US
Telephone Number : 215-345-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 09/22/2010

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