Doctor Name: | DR. VICTORIA ANN KELLOGG |
NPI Number: | 1225022460 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, CRNP, MBA |
License Number: | UP005195V |
Business Practice Address: | 112 W Main St Lock Haven, PA - 177451246 |
Business Phone Number: | 5707481895 |
Business Fax Number: | |
Mailing Address: | 261 Millgate Rd, BELLEFONTE |
State: | PA |
Postal Code: | 168238573 |
Phone Number: | 8143551871 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | UP005195V |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |