Basic Information
| Provider Information | |||||||||
| NPI: | 1356834691 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KERSTETTER | ||||||||
| FirstName: | ANGELA | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 533 TURKEY RUN RD | ||||||||
| Address2: | |||||||||
| City: | MIFFLINBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178447239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707134191 | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | SELINSGROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178701154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703720536 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2018 | ||||||||
| LastUpdateDate: | 06/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WW0101X | RN578970 | PA | Y | Nursing Service Providers | Registered Nurse | Women's Health Care, Ambulatory |
No ID Information.