Doctor Name: | MRS. JOANNE MARY KEGLOVITS |
NPI Number: | 1922128818 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | VP003402B |
Business Practice Address: | 2321 N Broad St Colmar, PA - 189159702 |
Business Phone Number: | 2159973600 |
Business Fax Number: | 2159979409 |
Mailing Address: | 380 Adams Ln, BATH |
State: | PA |
Postal Code: | 180149427 |
Phone Number: | 6108378715 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | VP003402B |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |