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NPI Code Detail

MEDICARE: DR. KRISTI LEE DIVELY DO

MEDICARE: DR. KRISTI LEE DIVELY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianOS012313PA
2207QA0401XAddiction Medicine (Family Medicine) PhysicianOS012313PA

General Provider Information

NPI Number : 1063447852
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTI LEE DIVELY DO
Provider Business Mailing Address
First Line : 555 N DUKE ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-2250
Country : US
Telephone Number : 717-544-8144
Fax Number : 717-544-8140
Provider Business Practice Location Address
First Line : 555 N DUKE ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-2250
Country : US
Telephone Number : 717-544-8144
Fax Number : 717-544-8140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 04/07/2026

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Directions to “ DR. KRISTI LEE DIVELY DO” Practice Location

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