Individual
MR. KENNETH CHARLES AGNEW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
5037 CRYSTAL DR, ERIE, PA 16505-2913
(814) 218-1850
Mailing address
5037 CRYSTAL DR, ERIE, PA 16505-2913
(814) 218-1850
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
SP025288
PA
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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