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Individual

JOHN M MODENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
2112 HARRISBURG PIKE, SUITE 202, LANCASTER, PA 17601-2644
(717) 544-3500
(717) 544-3501
Mailing address
2112 HARRISBURG PIKE, STE 202, LANCASTER, PA 17601-2644
(717) 869-4600
(717) 544-3501

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP013949
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP013949
LICENSE
PA
Enumeration date
06/05/2014
Last updated
03/09/2020
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