Individual
KEELY MCCLATCHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CPNP-PC
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
418 CAMPBELL AVE, HAVERTOWN, PA 19083-1633
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN650160
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP021691
PA
Other
Enumeration date
03/29/2020
Last updated
03/29/2020
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