Facts
- Status
- A
- Credential
- CRNP
- Type
- Individual
- Enumeration date
- 2020-07-16
- Last updated
- 2022-03-24
Specialties
Licenses
- License PA
- SP022035
Location
- Practice location
- 1040 LIGGETT AVE
- City
- READING PA
- Postal code
- 196111801
- Phone
- 484-220-2955
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.