MEDICARE: MS. SUSAN CATHERINE MALONEY MSN, CRNP, RN, BC

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	363LF0000X	Family Nurse Practitioner	VP004544B	PA

General Provider Information

NPI Number	:	1437216736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN CATHERINE MALONEY MSN, CRNP, RN, BC

Provider Business Mailing Address
First Line	:	305 MEADVILLE ST
Second Line	:	CENTENNIAL HALL
City	:	EDINBORO
State	:	PA
Zip	:	16444-0001
Country	:	US
Telephone Number	:	814-882-4322
Fax Number	:	814-732-2536

Provider Business Practice Location Address
First Line	:	1611 PEACH ST
Second Line	:	SUITE 455
City	:	ERIE
State	:	PA
Zip	:	16501-2109
Country	:	US
Telephone Number	:	814-453-4718
Fax Number	:	814-455-7463

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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