Provider Demographics
NPI:1669040259
Name:HISH, MARIAH EMILY (MSN, CRNP, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:EMILY
Last Name:HISH
Suffix:
Gender:F
Credentials:MSN, CRNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BALLY
Mailing Address - State:PA
Mailing Address - Zip Code:19503-9639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2591 BAGLYOS CIR UNIT C
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8043
Practice Address - Country:US
Practice Address - Phone:215-887-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022448363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health