Organization
PRACTITIONER LLC
Active
Other names
NP Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NINO KAVTARADZE CRNP (PRIMARY CARE PROVIDER, SHAREHOLDER)
(267) 223-7738
Entity
Organization
Contact information
Practice address
1200 BUSTLETON PIKE STE 16A3, FEASTERVILLE TREVOSE, PA 19053-4118
(267) 223-7738
(877) 416-0367
Mailing address
1200 BUSTLETON PIKE STE 16A3, FEASTERVILLE TREVOSE, PA 19053-4118
(267) 223-7738
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037033750001
—
PA
Enumeration date
06/25/2019
Last updated
01/29/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us