MEDICARE: MARLENE D SIERRA CNA

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
1	376K00000X	Nurse's Aide	9984196	PA

General Provider Information

NPI Number	:	1811120504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENE D SIERRA CNA

Provider Business Mailing Address
First Line	:	308 WASHINGTON ST
Second Line	:
City	:	DENVER
State	:	PA
Zip	:	17517-1212
Country	:	US
Telephone Number	:	717-283-3445
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 WASHINGTON ST
Second Line	:
City	:	DENVER
State	:	PA
Zip	:	17517-1212
Country	:	US
Telephone Number	:	717-283-3445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2009
Last Update Date	:	09/17/2009

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