Individual
KELLY GENSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-6952
(570) 823-8896
(570) 270-2692
Mailing address
1130 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-6952
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP016425
PA
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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