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General NPI Number Information
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NPI Number | 1912943358
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Entity Type | Individual
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Provider Name | MARY M RELICH-DUDAS CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 125 NORTH FRANKLIN DRIVE SUITE 1
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City | WASHINGTON
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State | PA
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Zip | 15301
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Country | US
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Telephone | 724-225-6500
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Fax | 724-225-8188
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Provider Business Mailing Address
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Address Line | 125 NORTH FRANKLIN DRIVE SUITE 1
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City | WASHINGTON
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State | PA
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Zip | 15301
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Country | US
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Telephone | 724-225-6500
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Fax | 724-225-8188
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | TP003346M
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License Number State | PA
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