Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP017842 | PA |
NPI | 1043737521 |
---|---|
Provider Name | Mrs. Erin Regan Kennedy-Ripley |
First Address | Bangor, PA 18013-9282 |
Second Address | Bethlehem, PA 18015-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2017 |
Last Update Date | 17/03/2018 |