Individual
KELLY A DEAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
100 EISENHOWER DR, HANOVER, PA 17331-5241
(717) 646-4201
(717) 646-4202
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 646-4201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP012067
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029989380059
—
PA
Enumeration date
04/04/2012
Last updated
10/18/2021
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