Individual
MISS KELLY ANNA FETTERHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
205 S FRONT ST, HARRISBURG, PA 17104-1619
(717) 231-8360
Mailing address
1699 POTTSVILLE ST, LYKENS, PA 17048-9633
(717) 395-4929
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP022261
PA
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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