Mrs. Mary Elizabeth Logan
Ms. Mary Elizabeth Manning · Nurse Practitioner (Family)

Address: 635 Maple Ave, Du Bois, PA 15801-2376
Phone: 8143714320

Mrs. Mary Elizabeth Logan (NPI# 1962917245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1962917245
Entity Type Individual
Full Name Mrs. Mary Elizabeth Logan
Other Name Ms. Mary Elizabeth Manning
Credential CRNP
Gender Female
Practice Address 635 Maple Ave
Du Bois
PA 15801-2376
Practice Telephone 8143714320
Mailing Address 100 Hospital Ave
Du Bois
PA 15801-1440
Mailing Telephone 8143714320
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2017-12-07
Last Update Date 2018-08-02

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LF0000X Nurse Practitioner · Family Physician Assistants & Advanced Practice Nursing Providers SP018275 PA

Other Provider Identifier

State Identifier Issuer Type Code
PA SP018275 OTHER CRNP LICENSE

Providers with the same name

NPI Name Taxonomy Address Enumeration
1457689226 Mary Alexandra Logan Doula 1822 E 32nd St, Vancouver, WA 98663-2976 2009-12-06
1720223951 Mary C Logan Occupational Therapist 49 Fenimore Ave, Garden City, NY 11530-1027 2008-12-02
1245440254 Mary Callaway Logan Counselor 1200 Ponce De Leon Ave Ne, Atlanta, GA 30306-4602 2007-05-22
1063958064 Mary Logan Counselor 255 Delaware Ave, Suite 300, Buffalo, NY 14202-2016 2017-01-13
1235576810 Mary Kathryn Logan Nurse Practitioner 316 Calhoun St, Charleston, SC 29401-1113 2013-05-23
1942517750 Mary Ellen Logan Registered Nurse 109 Elm St, Scituate, MA 02066-4034 2010-09-01
1356578876 Mary Ann Logan Marriage & Family Therapist 2500 Hospital Dr, Building 3, Mountain View, CA 94040-4106 2009-06-11
1013152982 Mary K Logan Counselor 15 Union St, 2nd Floor, Lawrence, MA 01840-1866 2008-12-08
1447472881 Mary Elizabeth Logan Pharmacy Technician 2799 W Grand Blvd, Detroit, MI 48202-2608 2007-05-03
1225021918 Mary Street Logan Anesthesiology 801 W Gordon St, Thomaston, GA 30286-3426 2005-08-26
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Physician Overview

NPI 1962917245
PAC ID by PECOS 5991065955
Professional Enrollment ID I20180212002781
Full Name Mary E Logan
Organization Legal Name DUBOIS REGIONAL MEDICAL CENTER
Phone Number 8143714320
Gender F
Graduation Year 2017
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 5890689715
Number of Group Practice Members 269
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
390086 PENN HIGHLAND DUBOIS
390052 CLEARFIELD HOSPITAL

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to comeā€¦

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134752587 Sarah Gwen Whiteman Nurse Practitioner 145 Hospital Ave Ste 200, Du Bois, PA 15801-1464 2020-02-13
1639543861 Nicole Lynn Hoover Nurse Practitioner 145 Hospital Ave Ste 101, Du Bois, PA 15801-1463 2015-11-27
1801498886 Jeri Bell Nurse Practitioner 33 Beaver Dr Ste 1, Du Bois, PA 15801-2434 2020-11-13
1912538216 Heather D Kovalick Nurse Practitioner 100 Hospital Ave, Du Bois, PA 15801-1440 2020-01-27
1811486707 Brittany Veltri Nurse Practitioner 145 Hospital Ave Ste 113, Du Bois, PA 15801-1463 2018-05-07
1487153524 Kristy Bowman Stephens Nurse Practitioner 145 Hospital Ave Ste 101, Du Bois, PA 15801-1463 2018-02-05
1245747120 Kristie Lynn Kline Nurse Practitioner 529 Sunflower Dr, Du Bois, PA 15801-2378 2018-01-02
1467966473 Michelle Evelyn Jacobson Nurse Practitioner 145 Hospital Ave Ste 205, Du Bois, PA 15801-1464 2017-11-29
1679004360 Aretta Straw Nurse Practitioner 190 W Park Ave, Suite 9, Du Bois, PA 15801-2277 2017-03-23
1871030296 Aleda Elise Elkin Nurse Practitioner 90 Beaver Dr Bldg C, Du Bois, PA 15801-2440 2017-01-24
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Office Location

Street Address 635 MAPLE AVE
City DU BOIS
State PA
Zip Code 15801-2376

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528002573 John Wade Lobb Psychologist 635 Maple Ave, Du Bois, PA 15801-2376 2006-06-16
1033661335 Bethany Lindemuth Social Worker 635 Maple Ave, Du Bois, PA 15801 2016-11-03
1881063279 Olivia Luzier Social Worker 635 Maple Ave, Du Bois, PA 15801-2376 2015-09-16
1851776397 Dubois Regional Medical Center - Penn Highlands Dubois East Campus Family Medicine 635 Maple Ave, Du Bois, PA 15801-2376 2015-07-27
1366836959 Arianne Zimmerman Counselor 635 Maple Ave, Du Bois, PA 15801-2376 2015-03-23
1487937199 Dubois Regional Medical Center Family Medicine 635 Maple Ave, Du Bois, PA 15801-2376 2011-09-20
1770893141 Megan E Lyle Physician Assistant 635 Maple Ave, Du Bois, PA 15801-2376 2010-10-19
1710296157 Dubois Regional Medical Center Family Medicine 635 Maple Ave, Du Bois, PA 15801 2010-10-04
1043523657 Huma Ansari Psychiatry & Neurology 635 Maple Ave, Du Bois, PA 15801-2376 2010-07-24
1851521850 Matthew Bridgman Clinical Neuropsychologist 635 Maple Ave, Du Bois, PA 15801-2376 2009-07-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215551452 Grace Polohonki Counselor 490 Jefers Street, Dubois, PA 15801 2020-06-03
1144869231 Richard Lee Kerstetter II Hearing Instrument Specialist 124 San Juan Rd, Du Bois, PA 15801 2020-01-06
1700368487 Holly Noel Knoll Counselor 490 Jeffers Street, Dubois, PA 15801 2018-08-30
1992298160 Dubois Regional Medical Center Family Medicine 145 Hospital Ave Ste 315, Du Bois, PA 15801 2018-06-12
1154814846 Sara Beth Stone Dietitian, Registered 16288 Treasure Lk, Du Bois, PA 15801 2018-06-07
1942790779 Wendi Dawn Wenzel Counselor 490 Jeffers St., Dubois, PA 15801 2018-05-17
1144748443 Nancy Foradora Massage Therapist 200 Narrows Creek Park Road, Dubois, PA 15801 2017-09-07
1679098891 Deborah Jean Mitchell Hearing Instrument Specialist 900 Beaver Drive, Dubois, PA 15801 2017-08-09
1861937757 Shaun M Kanouff Counselor 100 Caldwell Dr., Dubois, PA 15801 2016-12-30
1164897740 Drayer Physical Therapy Institute LLC Physical Therapist 873 Beaver Drive, Dubois, PA 15801 2015-12-08
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Competitor

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City DU BOIS
Zip Code 15801

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.