Provider Demographics
NPI:1629246640
Name:MAURER, MARTHA KATRINA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:KATRINA
Last Name:MAURER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 PARK STREET
Mailing Address - Street 2:WAYNE MEMORIAL HOSPITAL
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18508-1250
Mailing Address - Country:US
Mailing Address - Phone:570-253-8100
Mailing Address - Fax:
Practice Address - Street 1:601 PARK STREET
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431
Practice Address - Country:US
Practice Address - Phone:570-253-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010983363LF0000X
PARN316654L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse