Healthcare Provider Details

I. General information

NPI: 1386960086
Provider Name (Legal Business Name): MERRYLEE GROSSO MORSCHHAUSER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERRYLEE G GROSSO

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 GEORGETOWN ROAD
BART PA
17503-0152
US

IV. Provider business mailing address

319 S 6TH ST
INDIANA PA
15701-3044
US

V. Phone/Fax

Practice location:
  • Phone: 717-786-5506
  • Fax:
Mailing address:
  • Phone: 267-294-1020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010217
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: