Individual
KELLY A BEARER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1 NOLTE DR, KITTANNING, PA 16201-7111
(724) 543-8164
(724) 543-8616
Mailing address
PO BOX 579, KITTANNING, PA 16201-0579
(724) 543-8164
(724) 543-8616
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP004640B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN501266L
RN LICENSE
PA
01
—
SP004640B
RN PRACTITIONERS LICENSE
PA
Enumeration date
04/03/2007
Last updated
07/08/2007
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