Organization · Type 2 NPI

Practitioner LLC

Primary Care Nurse Practitioner · Feasterville Trevose, PA

NPI number 1497316996 Active

Practice location

1200 Bustleton Pike Ste 16A3
Feasterville Trevose, PA 19053-4118

Fax (877) 416-0367

Specialties and licenses

Taxonomy	Code	License
Primary Care Nurse Practitioner Primary	363LP2300X	None listed

Primary Care Nurse Practitioner: Definition to come...

Another provider at this address

Nino Kavtaradze, CRNPNurse Practitioner Feasterville Trevose, PA NPI 1639574841

NPI record

NPI: 1497316996
Entity type: Organization (Type 2)
Issued: Jun 25, 2019
Last updated: Jan 29, 2020
Status: Active

Other names

<unavail>
NP Medicine · doing business as
NP Medicine · doing business as

Authorized official

Mrs. Nino Kavtaradze, CRNP
Primary Care Provider, Shareholder
(267) 223-7738

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About NPI 1497316996

Practitioner LLC's National Provider Identifier is 1497316996, issued on Jun 25, 2019. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Feasterville Trevose, PA. The record was last updated on Jan 29, 2020.