Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Lynn Park, MSN, CRNP, FNP-C

Individual provider Family Medicine Physician · NPI 1114755345

Mallory Lynn Park, MSN, CRNP, FNP-C is a Nurse Practitioner in Ridgway, Pennsylvania. Qualified in 2023, 3 years ago. Practices with Dubois Regional Medical Center, a 422-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
3
Licensed in
PA
In the registry since
2024
Specialties on file
2
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Practice location Address checks out

250 W Main St
Ridgway, PA 15853-1611
Phone: (814) 772-8122
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence SP030067 (PA)
Family Medicine Physician Taxonomy 207Q00000X · Licence SP030067 (PA)

Record details

NPI number1114755345
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSN , CRNP , FNP-C
Sole proprietorNo
NPI enumeratedJuly 22, 2024
Last updated in NPPESJuly 22, 2024
Certification dateJuly 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Dubois Regional Medical Center — 422 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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