Individual
LEA JANEEN KEPHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
321 NORRISTOWN RD STE 100, AMBLER, PA 19002-2793
(267) 640-4675
Mailing address
914 E CATHEDRAL RD, PHILADELPHIA, PA 19128-1204
(215) 508-2694
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
RN507305L
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
UP006012H
PA
Other
Enumeration date
09/06/2008
Last updated
09/09/2008
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