Provider Demographics
NPI:1164287488
Name:BOSTICK, MARY WELSH (CNM)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:WELSH
Last Name:BOSTICK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:115 ROCKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2422
Mailing Address - Country:US
Mailing Address - Phone:610-608-8302
Mailing Address - Fax:
Practice Address - Street 1:609 W GERMANTOWN PIKE STE 220
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4261
Practice Address - Country:US
Practice Address - Phone:484-662-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife