Boesch, Kelly M

Boesch, Kelly M is an individual health care provider with primary practice located at 618 Cornwall Rd Building 2, Lebanon PA 17042-7089. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Boesch, Kelly M can be contacted via phone (717) 279-6700.

Contact Information

Primary practice address
618 Cornwall Rd Building 2 Lebanon PA 17042-7089
Fax: (717) 279-6759
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X SP013294 Pennsylvania

Profile Details

NPI number 1528492535
LBN Legal business name Boesch, Kelly M
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2013
Last updated Nov 6th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528492535 NPPES
Pennsylvania Other SP013294 LICENSE
Pennsylvania MEDICAID 102888103 0001 LICENSE

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