Provider Demographics
NPI:1730712514
Name:INFANTI MRAZ, MEGAN ANN (RN, PHD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ANN
Last Name:INFANTI MRAZ
Suffix:
Gender:F
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 JACK REYNOLDS WAY
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-1307
Mailing Address - Country:US
Mailing Address - Phone:302-379-2594
Mailing Address - Fax:
Practice Address - Street 1:930 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2878
Practice Address - Country:US
Practice Address - Phone:610-430-4408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN534325163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN534325OtherHRSA GRANT 20-006