Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP015085 | PA |
NPI | 1003290495 |
---|---|
Provider Name | Kristen Anne Leri |
First Address | Hamlin, PA 18427-0430 |
Second Address | Hamlin, PA 18427-0430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2015 |
Last Update Date | 22/07/2015 |