Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Pediatrics
Enumerated
Sep 21, 2020
License(s)
SP022343 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 941 CEDARWOOD AVE | West Chester, PA 19380-1404 | 410-259-4428 |
| LOCATION | 105 VINEYARD WAY | West Grove, PA 19390-8849 | 410-259-4428 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.