Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Dec 7, 2007
License(s)
SP008988 (PA), SP008988 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2608 KEISER BLVD | Wyomissing, PA 19610-3333 | 610-685-5864 |
| MAILING | 2608 KEISER BLVD | Wyomissing, PA 19610-3333 | 610-685-5864 |
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.