| Doctor Name: | CAROL A MEDURA |
| NPI Number: | 1588918650 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP012432 |
| Business Practice Address: | 233 S Prospect St Nanticoke, PA - 186342443 |
| Business Phone Number: | 5707350102 |
| Business Fax Number: | |
| Mailing Address: | 89 Fawn Ridge Rd, WHITE HAVEN |
| State: | PA |
| Postal Code: | 186613623 |
| Phone Number: | 5704430614 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP012432 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |