Individual
REGINA KELLY-HARTSHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
26NO/NN09043800
NJ
363LP0200X
Pediatric Nurse Practitioner
Primary
SP016207
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6831109
—
NJ
Enumeration date
09/06/2006
Last updated
11/13/2023
Update your record
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