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General NPI Number Information
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NPI Number | 1912932963
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Entity Type | Individual
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Provider Name | MARCIA J BATHURST MSN, CRNP, RN
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 881 HILLS PLZ SUITE 530
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City | EBENSBURG
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State | PA
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Zip | 15931-4213
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Country | US
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Telephone | 814-419-8084
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Fax | 814-419-8053
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Provider Business Mailing Address
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Address Line | 881 HILLS PLZ SUITE 530
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City | EBENSBURG
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State | PA
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Zip | 15931-4213
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Country | US
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Telephone | 814-419-8084
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Fax | 814-419-8053
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | TP004838B
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License Number State | PA
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