Basic Information
| Provider Information | |||||||||
| NPI: | 1407806037 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CURTIS | ||||||||
| FirstName: | KRISTEN | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1648 HUNTINGDON PIKE | ||||||||
| Address2: | MEDICAL STAFF OFFICE 1ST FLR | ||||||||
| City: | MEADOWBROOK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190468001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159383450 | ||||||||
| FaxNumber: | 2159383829 | ||||||||
| Practice Location | |||||||||
| Address1: | 910 2ND STREET PIKE | ||||||||
| Address2: | |||||||||
| City: | RICHBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189541527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153640777 | ||||||||
| FaxNumber: | 2675790720 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 07/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 26NN08284700 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 8685002 | 05 | NJ | MEDICAID |