Provider Demographics
NPI:1245010073
Name:SILVEIRA PELIN, MARY ELLEN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:SILVEIRA PELIN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-3412
Mailing Address - Country:US
Mailing Address - Phone:717-475-3214
Mailing Address - Fax:
Practice Address - Street 1:4230 CRUMS MILL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2898
Practice Address - Country:US
Practice Address - Phone:717-233-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine