Individual
KELLEN NA POVANDA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
118 MONAHAN AVE, DUNMORE, PA 18512-1700
(570) 344-0183
Mailing address
118 MONAHAN AVE, DUNMORE, PA 18512-1700
(570) 344-0183
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN318747
PA
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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