Provider Demographics
NPI:1225494099
Name:SEIFARTH, MARYSTUART D (CRNP, BSN, MSN)
Entity Type:Individual
Prefix:
First Name:MARYSTUART
Middle Name:D
Last Name:SEIFARTH
Suffix:
Gender:F
Credentials:CRNP, BSN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:
Practice Address - Street 1:501 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2353
Practice Address - Country:US
Practice Address - Phone:717-765-3648
Practice Address - Fax:717-765-3647
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007307260043OtherMEDICAID GROUP #
PA867633OtherGROUP MEDICARE #
PA103090309Medicaid
PA103090309Medicaid