Individual
MS. KIMNGAN THI VELOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2401 PARK DR STE 101, HARRISBURG, PA 17110-9303
(717) 686-9842
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
(717) 724-6500
(717) 721-6510
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP015392
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103105401
—
PA
Enumeration date
08/17/2015
Last updated
11/01/2019
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