Provider Demographics
NPI:1669756516
Name:HANLEY, MARY JO (CRNP)
Entity type:Individual
Prefix:
First Name:MARY JO
Middle Name:
Last Name:HANLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:1929 LINCOLN HWY E STE 150
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3685
Mailing Address - Country:US
Mailing Address - Phone:717-947-6535
Mailing Address - Fax:
Practice Address - Street 1:1929 LINCOLN HWY E STE 100
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3347
Practice Address - Country:US
Practice Address - Phone:717-947-6535
Practice Address - Fax:717-397-6057
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP011621363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health