Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP019196 | PA |
NPI | 1497220065 |
---|---|
Provider Name | Chelsea Lynn Kerrigan |
First Address | Willow Grove, PA 19090-1226 |
Second Address | Philadelphia, PA 19114-4200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2018 |
Last Update Date | 03/06/2021 |