Provider Demographics
NPI:1710975552
Name:SPENGLER, MARY P (CRNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:P
Last Name:SPENGLER
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:SAINT LUKE'S HOSPITAL
Mailing Address - Street 2:801 OSTRUM STREET
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-4009
Mailing Address - Country:US
Mailing Address - Phone:610-954-4761
Mailing Address - Fax:610-954-2380
Practice Address - Street 1:501 CETRONIA RD STE 120
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9569
Practice Address - Country:US
Practice Address - Phone:484-426-2520
Practice Address - Fax:866-849-6463
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN243934L163W00000X
PASP007604363LF0000X, 363LX0001X
PATP 003616G363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA339377OtherHIGHMARK
PAP00096351OtherRAIL ROAD MEDICARE
PA0339377OtherKHP CENTRAL
PAS62203Medicare UPIN
PA0339377OtherKHP CENTRAL