MARIE SUSAN GAETANO CRNP - NPI 1295766046 - Nurse Practitioner in Enola, PA

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

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About Marie Susan Gaetano Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIE SUSAN GAETANO CRNP (NPI 1295766046) is an individual family provider in Enola, Pennsylvania, licensed in Pennsylvania (SP008299) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1295766046

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARIE SUSAN GAETANOCredential: CRNP

Location Address4470 VALLEY STEnola, PA 17025-1443

Mailing Address3 Walnut St, Suite 206Lemoyne, PA 17043-1168 · (717) 761-0208 · Fax (717) 761-2023

Phone(717) 732-8883

Fax(717) 732-1640

Sole ProprietorNo

Enumeration DateJuly 6, 2006

Last NPPES UpdateAugust 18, 2009

✔ NPI 1295766046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in PA · SP008299

4470 VALLEY ST, Enola, PA 17025

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Other Names 1

Former Name (1)Marie Susan Walsh

Other Identifiers 1

Medicare PIN158044PA

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONATHAN BECKETT TOCKS MD

Family Medicine