Provider Demographics
NPI:1881689982
Name:MANSPEAKER, CAROL A (CNM)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:MANSPEAKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 S KIMBERLY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2022
Mailing Address - Country:US
Mailing Address - Phone:814-445-3535
Mailing Address - Fax:814-445-3245
Practice Address - Street 1:229 S KIMBERLY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2022
Practice Address - Country:US
Practice Address - Phone:814-445-3535
Practice Address - Fax:814-445-3245
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008428L176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA278112OtherHIGHMARK BLUE SHIELD
PA319261OtherUPMC HEALTH PLAN
PA0017505600002Medicaid
PAS81887Medicare UPIN
PA0017505600002Medicaid