Healthcare Provider Details

I. General information

NPI: 1023454840
Provider Name (Legal Business Name): DONNA R MASON R.N., C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 MALE RD
WIND GAP PA
18091-1513
US

IV. Provider business mailing address

951 MALE RD
WIND GAP PA
18091-1513
US

V. Phone/Fax

Practice location:
  • Phone: 610-654-1000
  • Fax: 610-654-1004
Mailing address:
  • Phone: 610-654-1000
  • Fax: 610-654-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN600595
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number26NR14029200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP014285
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: