Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | VP004789N | PA |
NPI | 1033378252 |
---|---|
Provider Name | Kelly A Moretski |
First Address | Harleysville, PA 19438-2999 |
Second Address | Sellersville, PA 18960-1575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 03/06/2008 |