Individual
KELLYN O BERTOLAZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN
Contact information
Practice address
2246 BUSTARD RD, LANSDALE, PA 19446-5717
(610) 308-1349
Mailing address
1020 1ST AVE, KING OF PRUSSIA, PA 19406-1310
(484) 566-5464
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN283246L
PA
163WA2000X
Administrator Registered Nurse
RN283246L
PA
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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