| Kellie Nicole Meehan, | |
|
451 3rd Ave, Kingston, PA 18704-5802 | |
| (570) 288-6543 | |
| Not Available |
| Full Name | Kellie Nicole Meehan |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 451 3rd Ave, Kingston, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346056926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | SP031261 (Pennsylvania) | Primary |
| Entity Name | Commonwealth Physician Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003238635 PECOS PAC ID: 2668696592 Enrollment ID: O20140617000549 |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Nicole Meehan, 200 N Main St, Plains, PA 18705-1540 Ph: (570) 574-6381 | Kellie Nicole Meehan, 451 3rd Ave, Kingston, PA 18704-5802 Ph: (570) 288-6543 |
Matthew Booth, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 480 Pierce St Ste 320, Kingston, PA 18704 Phone: 570-479-1627 | |
Mr. Thomas Mickowski, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 511 Pierce St, Kingston, PA 18704 Phone: 570-243-3300 Fax: 570-338-3993 | |
Anntoinette Romanowski, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 511 Pierce St, Kingston, PA 18704 Phone: 570-714-3333 | |
Angela Luongo, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 382 Pierce St, Kingston, PA 18704 Phone: 570-288-7231 | |
Stephanie Grencavage, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 390 Pierce St, Kingston, PA 18704 Phone: 570-288-3535 | |
Mrs. Glorymardy Cruz, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 511 Pierce St, Kingston, PA 18704 Phone: 570-714-3333 | |
Catherine Champi, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 610 Wyoming Ave, Suite 1, Kingston, PA 18704 Phone: 570-288-5441 Fax: 570-288-9613 |