Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jan 13, 2022
License(s)
SP025058 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 301 HEIGHTS LN APT 34D | Feasterville Trevose, PA 19053-7644 | 267-597-8022 |
| LOCATION | 595 W STATE ST | Doylestown, PA 18901-2554 | 215-345-2200 |
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.