Provider Demographics
NPI:1023454840
Name:MASON, DONNA R (RN, CRNP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:R
Last Name:MASON
Suffix:
Gender:F
Credentials:RN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 MALE RD
Mailing Address - Street 2:
Mailing Address - City:WIND GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18091-1513
Mailing Address - Country:US
Mailing Address - Phone:610-654-1000
Mailing Address - Fax:610-654-1004
Practice Address - Street 1:951 MALE RD
Practice Address - Street 2:
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-1513
Practice Address - Country:US
Practice Address - Phone:610-654-1000
Practice Address - Fax:610-654-1004
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN600595163WW0000X
NJ26NR14029200163WW0000X
PASP014285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA399541V8GMedicare PIN