Individual
KELLY LUNDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1045 FOURTH AVENUE, NEW KENSINGTON, PA 15068
(724) 335-9883
Mailing address
1045 FOURTH AVENUE, NEW KENSINGTON, PA 15068
(724) 335-9883
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN229334
PA
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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