Provider Demographics
NPI:1356761621
Name:SCOLLON-MCCARTHY, MAUREEN (CRNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SCOLLON-MCCARTHY
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 1:48 RICHARD LEE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1914
Mailing Address - Country:US
Mailing Address - Phone:610-933-3177
Mailing Address - Fax:
Practice Address - Street 1:34TH AND CIVIC CENTER BOULEVARD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-9182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN325385L163WP0000X
PAVP006113B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0000XNursing Service ProvidersRegistered NursePain Management