Provider Demographics
NPI:1659525889
Name:WERTZ, MARCIA TAYLOR (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:TAYLOR
Last Name:WERTZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:TAYLOR
Other - Last Name:HELFRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:420 E CENTRAL WAY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-1457
Mailing Address - Country:US
Mailing Address - Phone:814-623-3474
Mailing Address - Fax:814-623-3022
Practice Address - Street 1:420 E CENTRAL WAY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-1457
Practice Address - Country:US
Practice Address - Phone:814-623-3474
Practice Address - Fax:814-623-3022
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010053363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007307260037OtherMEDICAID GROUP #
PASP010053OtherLICENSE
PAP00768400OtherRAILROAD MEDICARE
PA867633OtherMEDICARE GROUP #
PA102368696Medicaid
PA25-1716306OtherINTERGROUP
PA25-1716306OtherINTERGROUP
PA867633OtherMEDICARE GROUP #