Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | SP021228 | PA |
NPI | 1083249072 |
---|---|
Provider Name | Kristen Ayrer |
First Address | Newtown, PA 18940-1640 |
Second Address | Langhorne, PA 19047-3201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2020 |
Last Update Date | 10/03/2020 |