Organization
VIA AFFILIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN JAYNE (REVENUE DIRECTOR)
(267) 370-5296
Entity
Organization
Contact information
Practice address
599 W STATE ST STE 307, DOYLESTOWN, PA 18901-2567
(215) 345-2489
(215) 489-7233
Mailing address
PO BOX 829641, PHILADELPHIA, PA 19182-9641
(267) 370-5296
(215) 230-3725
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
09/05/2025
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