Provider Demographics
NPI:1437216736
Name:MALONEY, SUSAN CATHERINE (MSN, CRNP, RN, BC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CATHERINE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MSN, CRNP, RN, BC
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:CATHERINE
Other - Last Name:MALONEY-YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CRNP, RN, BC
Mailing Address - Street 1:305 MEADVILLE ST
Mailing Address - Street 2:CENTENNIAL HALL
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16444-0001
Mailing Address - Country:US
Mailing Address - Phone:814-882-4322
Mailing Address - Fax:814-732-2536
Practice Address - Street 1:1611 PEACH ST
Practice Address - Street 2:SUITE 455
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2109
Practice Address - Country:US
Practice Address - Phone:814-453-4718
Practice Address - Fax:814-455-7463
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004544B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily