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Individual

KEVIN WANGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
2500 LISBURN RD, CAMP HILL, PA 17011-8005
(717) 737-4531
(717) 731-1007
Mailing address
1942 HEATHERTON DR, LANCASTER, PA 17601-3979
(717) 341-7645

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN653205
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP016803
PA

Other

Enumeration date
03/11/2014
Last updated
12/27/2018
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