Individual
KATELYN CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
925 CHESTNUT STREET, SUITE 320A, PHILADELPHIA, PA 19107
(215) 955-8874
Mailing address
925 CHESTNUT STREET, SUITE 320A, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
SP014629
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP014629
PA
Other
Enumeration date
12/19/2014
Last updated
05/21/2018
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